38D1010666 CLIA NUMBER - OREGON CLINIC-GI EAST, THE

Laboratory Demographics

  • CLIA Code: 38D1010666
  • Facility Name: OREGON CLINIC-GI EAST, THE
  • Facility Address: 1111 NE 99TH AVE STE 302
    PORTLAND, OR
    ZIP 97220
  • Facility Phone: 503 963-2707
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BETTY KIM
  • NPI Number: 1003944042
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 38D1010666
LAB Type Ambulatory Surgery Center
Facility Name OREGON CLINIC-GI EAST, THE
Street 1111 NE 99TH AVE STE 302
City PORTLAND
State OR
ZIP 97220
Phone 503 963-2707
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/20/2025
Certificate Expiration Date 3/19/2027
Facility Type Ambulatory Surgery Center
Lab Director BETTY KIM

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