38D2213869 CLIA NUMBER - MARQUIS FOREST GROVE ASSISTED LIVING FACILITY

Laboratory Demographics

CLIA Number: 38D2213869

Facility Name: MARQUIS FOREST GROVE ASSISTED LIVING FACILITY

Facility Address:
3336 19TH AVE
FOREST GROVE, OR
ZIP 97116
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Facility Phone Number: 503 359-1129

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1811371859

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	38D2213869
LAB Type	Assisted Living Facility
Facility Name	MARQUIS FOREST GROVE ASSISTED LIVING FACILITY
Street	3336 19TH AVE
City	FOREST GROVE
State	OR
ZIP	97116
Phone	503 359-1129
CertificateType	4
CertificateEffectiveDate	2/17/2023
CertificateExpirationDate	2/16/2025
FacilityType	Waiver

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