38D2047220 CLIA NUMBER - TODD GILLINGHAM MD LLC

Laboratory Demographics

  • CLIA Code: 38D2047220
  • Facility Name: TODD GILLINGHAM MD LLC
  • Facility Address: 17200 NW CORRIDOR CT STE 110
    BEAVERTON, OR
    ZIP 97006
  • Facility Phone: 503 614-8633
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TODD GILLINGHAM
  • NPI Number: 1033163027
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D2047220
LAB Type Physician Office
Facility Name TODD GILLINGHAM MD LLC
Street 17200 NW CORRIDOR CT STE 110
City BEAVERTON
State OR
ZIP 97006
Phone 503 614-8633
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2024
Certificate Expiration Date 9/18/2026
Facility Type Physician Office
Lab Director TODD GILLINGHAM

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