38D2170282 CLIA NUMBER - KAISER PERMANENTE DENTAL AT KEIZER STATION

Laboratory Demographics

  • CLIA Code: 38D2170282
  • Facility Name: KAISER PERMANENTE DENTAL AT KEIZER STATION
  • Facility Address: 5910 ULALI DRIVE NE
    KEIZER, OR
    ZIP 97303
  • Facility Phone: 503 383-3100
  • Facility Type: Other - DENTAL CLINIC
  • Facility Type: Waiver
  • Lab Director: ERIC PETERS
  • NPI Number: 1477664373
  • Taxonomy: 302R00000X - Health Maintenance Organization

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CLIA Record

Field Name Field Value
CLIA Number 38D2170282
LAB Type Other - DENTAL CLINIC
Facility Name KAISER PERMANENTE DENTAL AT KEIZER STATION
Street 5910 ULALI DRIVE NE
City KEIZER
State OR
ZIP 97303
Phone 503 383-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2023
Certificate Expiration Date 8/6/2025
Facility Type Other - DENTAL CLINIC
Lab Director ERIC PETERS

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This page was last updated on: 6/4/2025