38D2175852 CLIA NUMBER - OLSON PEDIATRIC CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 38D2175852
  • Facility Name: OLSON PEDIATRIC CLINIC, LLC
  • Facility Address: 16463 BOONES FERRY RD, SUITE 400
    LAKE OSWEGO, OR
    ZIP 97035
  • Facility Phone: 503 635-3743
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELIZABETH GRAFF
  • NPI Number: 1588902902
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 38D2175852
LAB Type Physician Office
Facility Name OLSON PEDIATRIC CLINIC, LLC
Street 16463 BOONES FERRY RD, SUITE 400
City LAKE OSWEGO
State OR
ZIP 97035
Phone 503 635-3743
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Physician Office
Lab Director ELIZABETH GRAFF

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