38D2023853 CLIA NUMBER - CORNELL ROAD DIALYSIS

Laboratory Demographics

  • CLIA Code: 38D2023853
  • Facility Name: CORNELL ROAD DIALYSIS
  • Facility Address: 1700 NW 167TH PLACE SUITE 230
    BEAVERTON, OR
    ZIP 97006
  • Facility Phone: 503 439-8829
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: PEI-LI WANG MD
  • NPI Number: 1548552003
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2023853
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name CORNELL ROAD DIALYSIS
Street 1700 NW 167TH PLACE SUITE 230
City BEAVERTON
State OR
ZIP 97006
Phone 503 439-8829
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director PEI-LI WANG MD

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