38D2021012 CLIA NUMBER - CONCENTRA - TANASBOURNE

Laboratory Demographics

  • CLIA Code: 38D2021012
  • Facility Name: CONCENTRA - TANASBOURNE
  • Facility Address: 2225 NW TOWNCENTER DR
    BEAVERTON, OR
    ZIP 97006
  • Facility Phone: 503 726-1021
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TERRYOL NOALL
  • NPI Number: 1881991115
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2021012
LAB Type Physician Office
Facility Name CONCENTRA - TANASBOURNE
Street 2225 NW TOWNCENTER DR
City BEAVERTON
State OR
ZIP 97006
Phone 503 726-1021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2025
Certificate Expiration Date 1/3/2027
Facility Type Physician Office
Lab Director TERRYOL NOALL

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