38D2166408 CLIA NUMBER - SURGERY CENTER AT ST VINCENT, LLC DBA EAST PAVILION SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 38D2166408
  • Facility Name: SURGERY CENTER AT ST VINCENT, LLC DBA EAST PAVILION SURGERY CENTER
  • Facility Address: 9135 SW BARNES ROAD, SUITE 161
    PORTLAND, OR
    ZIP 97225
  • Facility Phone: 503 991-9976
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ANAND JAIN
  • NPI Number: 1316449168
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2166408
LAB Type Ambulatory Surgery Center
Facility Name SURGERY CENTER AT ST VINCENT, LLC DBA EAST PAVILION SURGERY CENTER
Street 9135 SW BARNES ROAD, SUITE 161
City PORTLAND
State OR
ZIP 97225
Phone 503 991-9976
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2025
Certificate Expiration Date 5/15/2027
Facility Type Ambulatory Surgery Center
Lab Director ANAND JAIN

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