38D2248298 CLIA NUMBER - STEPHANIE GARDENS

Laboratory Demographics

  • CLIA Code: 38D2248298
  • Facility Name: STEPHANIE GARDENS
  • Facility Address: 19751 SE STARK ST
    PORTLAND, OR
    ZIP 97233
  • Facility Phone: 971 274-2751
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ALEKSANDR A. VINOKUROV
  • NPI Number: 1720060353
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 38D2248298
LAB Type Assisted Living Facility
Facility Name STEPHANIE GARDENS
Street 19751 SE STARK ST
City PORTLAND
State OR
ZIP 97233
Phone 971 274-2751
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/12/2024
Certificate Expiration Date 1/11/2026
Facility Type Assisted Living Facility
Lab Director ALEKSANDR A. VINOKUROV

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