38D2184114 CLIA NUMBER - RECOVERY WORKS NW

Laboratory Demographics

CLIA Number: 38D2184114

Facility Name: RECOVERY WORKS NW

Facility Address:
12540 SW MAIN ST SUITE 202
TIGARD, OR
ZIP 97223
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Facility Phone Number: 503 906-9995

Facility Type: Other - CHEM DEP OUTPATIENT TREAT

Certificate Type: Waiver

NPI Number: 1083010094

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D2184114
LAB Type	Other - CHEM DEP OUTPATIENT TREAT
Facility Name	RECOVERY WORKS NW
Street	12540 SW MAIN ST SUITE 202
City	TIGARD
State	OR
ZIP	97223
Phone	503 906-9995
CertificateType	4
CertificateEffectiveDate	5/14/2024
CertificateExpirationDate	5/13/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024