38D2059832 CLIA NUMBER - TANASBOURNE DENTAL OFFICE

Laboratory Demographics

  • CLIA Code: 38D2059832
  • Facility Name: TANASBOURNE DENTAL OFFICE
  • Facility Address: 10315 NE TANASBOURNE DR SUITE 300
    HILLSBORO, OR
    ZIP 97124
  • Facility Phone: 503 531-1700
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: NIPOON DAVE
  • NPI Number: 1174708457
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 38D2059832
LAB Type Practitioner Other
Facility Name TANASBOURNE DENTAL OFFICE
Street 10315 NE TANASBOURNE DR SUITE 300
City HILLSBORO
State OR
ZIP 97124
Phone 503 531-1700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Practitioner Other
Lab Director NIPOON DAVE

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