38D2197499 CLIA NUMBER - W2 POWELL VALLEY, LLC

Laboratory Demographics

  • CLIA Code: 38D2197499
  • Facility Name: W2 POWELL VALLEY, LLC
  • Facility Address: 4001 SE 182ND AVENUE
    GRESHAM, OR
    ZIP 97030
  • Facility Phone: (503) 706-6918
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JADINE A. CABRERA
  • NPI Number: 1861092520
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 38D2197499
LAB Type Assisted Living Facility
Facility Name W2 POWELL VALLEY, LLC
Street 4001 SE 182ND AVENUE
City GRESHAM
State OR
ZIP 97030
Phone 5037066918
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Assisted Living Facility
Lab Director JADINE A. CABRERA

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This page was last updated on: 5/18/2026