38D1095014 CLIA NUMBER - NORTHWEST URGENT CARE PHASE I LLC

Laboratory Demographics

  • CLIA Code: 38D1095014
  • Facility Name: NORTHWEST URGENT CARE PHASE I LLC
  • Facility Address: 22262 NE GLISAN ST
    GRESHAM, OR
    ZIP 97030
  • Facility Phone: 503 489-2024
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: LORI FARRELL
  • NPI Number: 1205207073
  • Taxonomy: 335E00000X - Prosthetic/Orthotic Supplier

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CLIA Record

Field Name Field Value
CLIA Number 38D1095014
LAB Type Other - URGENT CARE
Facility Name NORTHWEST URGENT CARE PHASE I LLC
Street 22262 NE GLISAN ST
City GRESHAM
State OR
ZIP 97030
Phone 503 489-2024
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2025
Certificate Expiration Date 1/31/2027
Facility Type Other - URGENT CARE
Lab Director LORI FARRELL

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