38D2050387 CLIA NUMBER - ROSE CITY DIALYSIS LLC DBA FRESENIUS MAYWOOD PARK

Laboratory Demographics

  • CLIA Code: 38D2050387
  • Facility Name: ROSE CITY DIALYSIS LLC DBA FRESENIUS MAYWOOD PARK
  • Facility Address: 11909 NE GLENN WIDING DRIVE
    PORTLAND, OR
    ZIP 97220
  • Facility Phone: 503 255-3464
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: STANLEY M BOWER
  • NPI Number: 1023367893
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2050387
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ROSE CITY DIALYSIS LLC DBA FRESENIUS MAYWOOD PARK
Street 11909 NE GLENN WIDING DRIVE
City PORTLAND
State OR
ZIP 97220
Phone 503 255-3464
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 End Stage Renal Disease Dialysis Facility
Lab Director STANLEY M BOWER

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