38D2072513 CLIA NUMBER - SHANTI RECOVERY AND WELLNESS

Laboratory Demographics

  • CLIA Code: 38D2072513
  • Facility Name: SHANTI RECOVERY AND WELLNESS
  • Facility Address: 3769 SE MILWAUKIE AVE
    PORTLAND, OR
    ZIP 97202
  • Facility Phone: 503 235-2120
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBBIE BAHL MD
  • NPI Number: 1073978284
  • Taxonomy: 207QA0401X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D2072513
LAB Type Physician Office
Facility Name SHANTI RECOVERY AND WELLNESS
Street 3769 SE MILWAUKIE AVE
City PORTLAND
State OR
ZIP 97202
Phone 503 235-2120
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Physician Office
Lab Director ROBBIE BAHL MD

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