38D2195111 CLIA NUMBER - RACKLEFF PLACE

Laboratory Demographics

  • CLIA Code: 38D2195111
  • Facility Name: RACKLEFF PLACE
  • Facility Address: 655 SW 13TH AVE
    CANBY, OR
    ZIP 97013
  • Facility Phone: 503 266-9555
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: LYNN VICKERS
  • NPI Number: 1649895921
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 38D2195111
LAB Type Assisted Living Facility
Facility Name RACKLEFF PLACE
Street 655 SW 13TH AVE
City CANBY
State OR
ZIP 97013
Phone 503 266-9555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2024
Certificate Expiration Date 10/5/2026
Facility Type Assisted Living Facility
Lab Director LYNN VICKERS

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