38D1073258 CLIA NUMBER - WESTSIDE SURGERY CENTER

Laboratory Demographics

CLIA Number: 38D1073258

Facility Name: WESTSIDE SURGERY CENTER

Facility Address:
13240 SW PACIFIC HWY
TIGARD, OR
ZIP 97223
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Facility Phone Number: 503 639-6571

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1811978356

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D1073258
LAB Type	Ambulatory Surgery Center
Facility Name	WESTSIDE SURGERY CENTER
Street	13240 SW PACIFIC HWY
City	TIGARD
State	OR
ZIP	97223
Phone	503 639-6571
CertificateType	4
CertificateEffectiveDate	9/5/2023
CertificateExpirationDate	9/4/2025
FacilityType	Waiver

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