38D2088311 CLIA NUMBER - HALE HEALTH LLC

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Laboratory Demographics

CLIA Number: 38D2088311

Facility Name: HALE HEALTH LLC

Facility Address:
18813 SW MARTINAZZI AVE
TUALATIN, OR
ZIP 97062
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Facility Phone Number: 503 765-5265

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1134558976

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D2088311
LAB Type	Physician Office
Facility Name	HALE HEALTH LLC
Street	18813 SW MARTINAZZI AVE
City	TUALATIN
State	OR
ZIP	97062
Phone	503 765-5265
CertificateType	4
CertificateEffectiveDate	12/12/2022
CertificateExpirationDate	12/11/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024