38D2050384 CLIA NUMBER - NORTHWEST SPINE AND LASER SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 38D2050384
  • Facility Name: NORTHWEST SPINE AND LASER SURGERY CENTER LLC
  • Facility Address: 8995 SW MILEY ROAD SUITE 204
    WILSONVILLE, OR
    ZIP 97070
  • Facility Phone: 801 694-8600
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RAFE J. SALES MD
  • NPI Number: 1548503477
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 38D2050384
LAB Type Ambulatory Surgery Center
Facility Name NORTHWEST SPINE AND LASER SURGERY CENTER LLC
Street 8995 SW MILEY ROAD SUITE 204
City WILSONVILLE
State OR
ZIP 97070
Phone 801 694-8600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2024
Certificate Expiration Date 11/26/2026
Facility Type Ambulatory Surgery Center
Lab Director RAFE J. SALES MD

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