38D2234272 CLIA NUMBER - TANASBOURNE KPOJ

Laboratory Demographics

  • CLIA Code: 38D2234272
  • Facility Name: TANASBOURNE KPOJ
  • Facility Address: 17885 NW EVERGREEN PKWY
    BEAVERTON, OR
    ZIP 97006
  • Facility Phone: 503 505-3857
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JOHN P. SEYMOUR
  • NPI Number: 1245436385
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 38D2234272
LAB Type Physician Office
Facility Name TANASBOURNE KPOJ
Street 17885 NW EVERGREEN PKWY
City BEAVERTON
State OR
ZIP 97006
Phone 503 505-3857
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2025
Certificate Expiration Date 8/29/2027
Facility Type Physician Office
Lab Director DR. JOHN P. SEYMOUR

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