38D1065369 CLIA NUMBER - POHALA - A PLACE OF HEALTH PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 38D1065369
  • Facility Name: POHALA - A PLACE OF HEALTH PRIMARY CARE
  • Facility Address: 7477 SE 52ND AVE
    PORTLAND, OR
    ZIP 97206
  • Facility Phone: 503 572-4196
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JULIE E FOSTER MSN FNP
  • NPI Number: 1689025231
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 38D1065369
LAB Type Practitioner Other
Facility Name POHALA - A PLACE OF HEALTH PRIMARY CARE
Street 7477 SE 52ND AVE
City PORTLAND
State OR
ZIP 97206
Phone 503 572-4196
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Practitioner Other
Lab Director JULIE E FOSTER MSN FNP

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