38D2170021 CLIA NUMBER - NORTHWEST EXTREMITY SPECIALISTS

Laboratory Demographics

  • CLIA Code: 38D2170021
  • Facility Name: NORTHWEST EXTREMITY SPECIALISTS
  • Facility Address: 9115 SW OLESON RD, STE 205
    PORTLAND, OR
    ZIP 97223
  • Facility Phone: 503 245-2420
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: MICHAEL V. MESA
  • NPI Number: 1386229219
  • Taxonomy: 261QP1100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2170021
LAB Type Independent
Facility Name NORTHWEST EXTREMITY SPECIALISTS
Street 9115 SW OLESON RD, STE 205
City PORTLAND
State OR
ZIP 97223
Phone 503 245-2420
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 11/4/2023
Certificate Expiration Date 11/3/2025
Facility Type Independent
Lab Director MICHAEL V. MESA

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