38D1078738 CLIA NUMBER - MIRANDA MCCORMACK MD LLC

Laboratory Demographics

  • CLIA Code: 38D1078738
  • Facility Name: MIRANDA MCCORMACK MD LLC
  • Facility Address: 5040 SW GRIFFITH DR #201
    BEAVERTON, OR
    ZIP 97005
  • Facility Phone: 503 616-2224
  • Facility Type: Tissue Bank/Repositories
  • Facility Type: Waiver
  • Lab Director: MIRANDA C. MCCORMACK MD
  • NPI Number: 1043488166
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D1078738
LAB Type Tissue Bank/Repositories
Facility Name MIRANDA MCCORMACK MD LLC
Street 5040 SW GRIFFITH DR #201
City BEAVERTON
State OR
ZIP 97005
Phone 503 616-2224
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2024
Certificate Expiration Date 1/14/2026
Facility Type Tissue Bank/Repositories
Lab Director MIRANDA C. MCCORMACK MD

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