38D2143975 CLIA NUMBER - FLOURISH INTEGRATIVE MEDICINE, LLC

Laboratory Demographics

  • CLIA Code: 38D2143975
  • Facility Name: FLOURISH INTEGRATIVE MEDICINE, LLC
  • Facility Address: 2505 SW SPRING GARDEN ST SUITE 200
    PORTLAND, OR
    ZIP 97219
  • Facility Phone: 503 432-8050
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MS. JENNIFER G. OWEN
  • NPI Number: 1366061798
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 38D2143975
LAB Type Physician Office
Facility Name FLOURISH INTEGRATIVE MEDICINE, LLC
Street 2505 SW SPRING GARDEN ST SUITE 200
City PORTLAND
State OR
ZIP 97219
Phone 503 432-8050
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Physician Office
Lab Director MS. JENNIFER G. OWEN

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