38D2019999 CLIA NUMBER - LAKE OSWEGO VISION CLINIC

Laboratory Demographics

  • CLIA Code: 38D2019999
  • Facility Name: LAKE OSWEGO VISION CLINIC
  • Facility Address: 15480 BOONES FERRY RD
    LAKE OSWEGO, OR
    ZIP 97035
  • Facility Phone: 503 635-1458
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID A WOLF OD
  • NPI Number: 1750506937
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 38D2019999
LAB Type Physician Office
Facility Name LAKE OSWEGO VISION CLINIC
Street 15480 BOONES FERRY RD
City LAKE OSWEGO
State OR
ZIP 97035
Phone 503 635-1458
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2024
Certificate Expiration Date 2/12/2026
Facility Type Physician Office
Lab Director DAVID A WOLF OD

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This page was last updated on: 3/20/2025