38D2197384 CLIA NUMBER - OSWEGO PLACE BY BONAVENTURE

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Laboratory Demographics

CLIA Number: 38D2197384

Facility Name: OSWEGO PLACE BY BONAVENTURE

Facility Address:
17450 PILKINGTON ROAD
LAKE OSWEGO, OR
ZIP 97035
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Facility Phone Number: 503 697-1025

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1588877724

Taxonomy: 305S00000X - Point of Service
This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.

CLIA Record

Field Name	Field Value
CLIA Number	38D2197384
LAB Type	Assisted Living Facility
Facility Name	OSWEGO PLACE BY BONAVENTURE
Street	17450 PILKINGTON ROAD
City	LAKE OSWEGO
State	OR
ZIP	97035
Phone	503 697-1025
CertificateType	4
CertificateEffectiveDate	10/23/2022
CertificateExpirationDate	10/22/2024
FacilityType	Waiver

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