38D0982658 CLIA NUMBER - PACIFIC CATARACT AND LASER INSTITUTE

Laboratory Demographics

CLIA Number: 38D0982658

Facility Name: PACIFIC CATARACT AND LASER INSTITUTE

Facility Address:
19801 SW 72ND AVE SUITE 150
TUALATIN, OR
ZIP 97062
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Facility Phone Number: 503 691-2283

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1265609945

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D0982658
LAB Type	Ambulatory Surgery Center
Facility Name	PACIFIC CATARACT AND LASER INSTITUTE
Street	19801 SW 72ND AVE SUITE 150
City	TUALATIN
State	OR
ZIP	97062
Phone	503 691-2283
CertificateType	4
CertificateEffectiveDate	2/1/2023
CertificateExpirationDate	1/31/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024