38D2294771 CLIA NUMBER - MT HOOD FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 38D2294771
  • Facility Name: MT HOOD FAMILY MEDICINE
  • Facility Address: 22400 SE STARK ST, STE 105
    GRESHAM, OR
    ZIP 97030
  • Facility Phone: 503 218-3100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAUREN SUTTON
  • NPI Number: 1053476143
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 38D2294771
LAB Type Physician Office
Facility Name MT HOOD FAMILY MEDICINE
Street 22400 SE STARK ST, STE 105
City GRESHAM
State OR
ZIP 97030
Phone 503 218-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2023
Certificate Expiration Date 11/28/2025
Facility Type Physician Office
Lab Director LAUREN SUTTON

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