38D1034700 CLIA NUMBER - PROVIDENCE WOMEN'S CLINIC MILWAUKIE

Laboratory Demographics

  • CLIA Code: 38D1034700
  • Facility Name: PROVIDENCE WOMEN'S CLINIC MILWAUKIE
  • Facility Address: 10330 SE 32ND SUITE 305
    MILWAUKIE, OR
    ZIP 97222
  • Facility Phone: 503 513-1800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANYLLE KAPPLER
  • NPI Number: 1013086875
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D1034700
LAB Type Physician Office
Facility Name PROVIDENCE WOMEN'S CLINIC MILWAUKIE
Street 10330 SE 32ND SUITE 305
City MILWAUKIE
State OR
ZIP 97222
Phone 503 513-1800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Physician Office
Lab Director DANYLLE KAPPLER

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