38D2084893 CLIA NUMBER - AESTHETIC BREAST AND COSMETIC SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 38D2084893
  • Facility Name: AESTHETIC BREAST AND COSMETIC SURGERY CENTER
  • Facility Address: 10201 SE MAIN ST SUITE 20
    PORTLAND, OR
    ZIP 97216
  • Facility Phone: 503 253-3458
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MICHAEL F BOHLEY MD
  • NPI Number: 1710992680
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 38D2084893
LAB Type Ambulatory Surgery Center
Facility Name AESTHETIC BREAST AND COSMETIC SURGERY CENTER
Street 10201 SE MAIN ST SUITE 20
City PORTLAND
State OR
ZIP 97216
Phone 503 253-3458
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Ambulatory Surgery Center
Lab Director MICHAEL F BOHLEY MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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