38D2100352 CLIA NUMBER - OREGON OCCUPATIONAL MEDICINE

Laboratory Demographics

  • CLIA Code: 38D2100352
  • Facility Name: OREGON OCCUPATIONAL MEDICINE
  • Facility Address: 19365 SW 65TH AVE, SUITE 100
    TUALATIN, OR
    ZIP 97062
  • Facility Phone: 503 563-5382
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN R. BRADDOCK
  • NPI Number: 1215361928
  • Taxonomy: 261QX0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2100352
LAB Type Physician Office
Facility Name OREGON OCCUPATIONAL MEDICINE
Street 19365 SW 65TH AVE, SUITE 100
City TUALATIN
State OR
ZIP 97062
Phone 503 563-5382
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type Physician Office
Lab Director JOHN R. BRADDOCK

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