38D2216197 CLIA NUMBER - CREDENA HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 38D2216197
  • Facility Name: CREDENA HEALTH CLINIC
  • Facility Address: 5050 NE HOYT STREET, SUITE 222
    PORTLAND, OR
    ZIP 97213
  • Facility Phone: (503) 215-9968
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIKA KUSUMA
  • NPI Number: 1366101966
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2216197
LAB Type Pharmacy
Facility Name CREDENA HEALTH CLINIC
Street 5050 NE HOYT STREET, SUITE 222
City PORTLAND
State OR
ZIP 97213
Phone 5032159968
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2025
Certificate Expiration Date 3/9/2027
Facility Type Pharmacy
Lab Director DANIKA KUSUMA

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This page was last updated on: 6/29/2026