38D2136696 CLIA NUMBER - NORTHWEST SURGICAL SPECIALISTS, PC DBA REBOUND

Laboratory Demographics

  • CLIA Code: 38D2136696
  • Facility Name: NORTHWEST SURGICAL SPECIALISTS, PC DBA REBOUND
  • Facility Address: 4811 SW MEADOWS RD SUITE 101
    LAKE OSWEGO, OR
    ZIP 97035
  • Facility Phone: 360 254-6161
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. STEPHEN R. SOUTHERLAND
  • NPI Number: 1548782022
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 38D2136696
LAB Type Physician Office
Facility Name NORTHWEST SURGICAL SPECIALISTS, PC DBA REBOUND
Street 4811 SW MEADOWS RD SUITE 101
City LAKE OSWEGO
State OR
ZIP 97035
Phone 360 254-6161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2025
Certificate Expiration Date 9/12/2027
Facility Type Physician Office
Lab Director DR. STEPHEN R. SOUTHERLAND

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