38D2004160 CLIA NUMBER - PROVIDENCE SEASIDE ANTI-COAGULATION CLINIC

Laboratory Demographics

  • CLIA Code: 38D2004160
  • Facility Name: PROVIDENCE SEASIDE ANTI-COAGULATION CLINIC
  • Facility Address: 725 S WAHANNA RD
    SEASIDE, OR
    ZIP 97138
  • Facility Phone: 503 717-7351
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT MORSE DO
  • NPI Number: 1952449985
  • Taxonomy: 282NR1301X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 38D2004160
LAB Type Pharmacy
Facility Name PROVIDENCE SEASIDE ANTI-COAGULATION CLINIC
Street 725 S WAHANNA RD
City SEASIDE
State OR
ZIP 97138
Phone 503 717-7351
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2024
Certificate Expiration Date 2/25/2026
Facility Type Pharmacy
Lab Director ROBERT MORSE DO

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