38D2319413 CLIA NUMBER - REVIANCE PORTLAND, LLC

Laboratory Demographics

  • CLIA Code: 38D2319413
  • Facility Name: REVIANCE PORTLAND, LLC
  • Facility Address: 9200 SE SUNNYBROOK BLVD SUITE 200
    CLACKAMAS, OR
    ZIP 97015
  • Facility Phone: 503 953-1230
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES CHAN
  • NPI Number: 1497474993
  • Taxonomy: 2082S0099X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 38D2319413
LAB Type Physician Office
Facility Name REVIANCE PORTLAND, LLC
Street 9200 SE SUNNYBROOK BLVD SUITE 200
City CLACKAMAS
State OR
ZIP 97015
Phone 503 953-1230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Physician Office
Lab Director JAMES CHAN

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