38D2021012 CLIA NUMBER - CONCENTRA - TANASBOURNE

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Laboratory Demographics

CLIA Number: 38D2021012

Facility Name: CONCENTRA - TANASBOURNE

Facility Address:
2225 NW TOWN CENTER DR
BEAVERTON, OR
ZIP 97006
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Facility Phone Number: 503 726-1021

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1881991115

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D2021012
LAB Type	Physician Office
Facility Name	CONCENTRA - TANASBOURNE
Street	2225 NW TOWN CENTER DR
City	BEAVERTON
State	OR
ZIP	97006
Phone	503 726-1021
CertificateType	4
CertificateEffectiveDate	1/4/2023
CertificateExpirationDate	1/3/2025
FacilityType	Waiver

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