38D2194426 CLIA NUMBER - SENIOR HAVEN RCF

Laboratory Demographics

  • CLIA Code: 38D2194426
  • Facility Name: SENIOR HAVEN RCF
  • Facility Address: 12140 SE FOSTER RD
    PORTLAND, OR
    ZIP 97266
  • Facility Phone: 971 271-8975
  • Facility Type: Other - RESIDENTIAL CARE FACILITY
  • Facility Type: Waiver
  • Lab Director: OLGA MAXIMOV
  • NPI Number: 1700408010
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 38D2194426
LAB Type Other - RESIDENTIAL CARE FACILITY
Facility Name SENIOR HAVEN RCF
Street 12140 SE FOSTER RD
City PORTLAND
State OR
ZIP 97266
Phone 971 271-8975
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Other - RESIDENTIAL CARE FACILITY
Lab Director OLGA MAXIMOV

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