38D2205966 CLIA NUMBER - POWELL VALLEY WELLNESS

Laboratory Demographics

  • CLIA Code: 38D2205966
  • Facility Name: POWELL VALLEY WELLNESS
  • Facility Address: 4253 SE 182ND AVENUE
    GRESHAM, OR
    ZIP 97030
  • Facility Phone: 503 661-5090
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EMMA M. NEIWORTH PETSHOW
  • NPI Number: 1831641505
  • Taxonomy: 261Q00000X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 38D2205966
LAB Type Physician Office
Facility Name POWELL VALLEY WELLNESS
Street 4253 SE 182ND AVENUE
City GRESHAM
State OR
ZIP 97030
Phone 503 661-5090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type Physician Office
Lab Director EMMA M. NEIWORTH PETSHOW

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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