38D2077511 CLIA NUMBER - PETROFF CENTER

Laboratory Demographics

  • CLIA Code: 38D2077511
  • Facility Name: PETROFF CENTER
  • Facility Address: 17720 JEAN WAY #100
    LAKE OSWEGO, OR
    ZIP 97035
  • Facility Phone: 503 635-4886
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARK A PETROFF MD
  • NPI Number: 1144365941
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 38D2077511
LAB Type Ambulatory Surgery Center
Facility Name PETROFF CENTER
Street 17720 JEAN WAY #100
City LAKE OSWEGO
State OR
ZIP 97035
Phone 503 635-4886
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/8/2024
Certificate Expiration Date 5/7/2026
Facility Type Ambulatory Surgery Center
Lab Director MARK A PETROFF MD

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