38D1003327 CLIA NUMBER - LEGACY CLINIC GOOD SAMARITAN

Laboratory Demographics

  • CLIA Code: 38D1003327
  • Facility Name: LEGACY CLINIC GOOD SAMARITAN
  • Facility Address: 1200 NW 23RD AVENUE
    PORTLAND, OR
    ZIP 97210
  • Facility Phone: 503 413-7074
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: JAMES P. BORDEN
  • NPI Number: 1902827272
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D1003327
LAB Type Community Clinic
Facility Name LEGACY CLINIC GOOD SAMARITAN
Street 1200 NW 23RD AVENUE
City PORTLAND
State OR
ZIP 97210
Phone 503 413-7074
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/27/2024
Certificate Expiration Date 8/26/2026
Facility Type Community Clinic
Lab Director JAMES P. BORDEN

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This page was last updated on: 9/29/2025