38D2157224 CLIA NUMBER - BRIDGEPORT IMMEDIATE CARE

Laboratory Demographics

  • CLIA Code: 38D2157224
  • Facility Name: BRIDGEPORT IMMEDIATE CARE
  • Facility Address: 18040 SW LOWER BOONES FERRY RD
    TIGARD, OR
    ZIP 97224
  • Facility Phone: 503 216-0724
  • Facility Type: Other - IMMEDIATE CARE
  • Facility Type: Waiver
  • Lab Director: DR. SEAN BRACHVOGEL
  • NPI Number: 1104246008
  • Taxonomy: 261Q00000X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 38D2157224
LAB Type Other - IMMEDIATE CARE
Facility Name BRIDGEPORT IMMEDIATE CARE
Street 18040 SW LOWER BOONES FERRY RD
City TIGARD
State OR
ZIP 97224
Phone 503 216-0724
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Other - IMMEDIATE CARE
Lab Director DR. SEAN BRACHVOGEL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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