38D2156260 CLIA NUMBER - WESTERNU HEALTH OLIVER STATION

Laboratory Demographics

CLIA Number: 38D2156260

Facility Name: WESTERNU HEALTH OLIVER STATION

Facility Address:
5909 SE 92ND AVENUE
PORTLAND, OR
ZIP 97266
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Facility Phone Number: 503 771-0055

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1942791611

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	38D2156260
LAB Type	Physician Office
Facility Name	WESTERNU HEALTH OLIVER STATION
Street	5909 SE 92ND AVENUE
City	PORTLAND
State	OR
ZIP	97266
Phone	503 771-0055
CertificateType	4
CertificateEffectiveDate	10/12/2022
CertificateExpirationDate	10/11/2024
FacilityType	Waiver

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