38D2031685 CLIA NUMBER - WAVERLY LAKE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 38D2031685
  • Facility Name: WAVERLY LAKE SURGERY CENTER
  • Facility Address: 633 WAVERLY DR SE
    ALBANY, OR
    ZIP 97322
  • Facility Phone: 541 918-4210
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PETER C. TSAI
  • NPI Number: 1851520514
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2031685
LAB Type Ambulatory Surgery Center
Facility Name WAVERLY LAKE SURGERY CENTER
Street 633 WAVERLY DR SE
City ALBANY
State OR
ZIP 97322
Phone 541 918-4210
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2023
Certificate Expiration Date 10/24/2025
Facility Type Ambulatory Surgery Center
Lab Director PETER C. TSAI

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