38D2327730 CLIA NUMBER - ELITE PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 38D2327730
  • Facility Name: ELITE PRIMARY CARE LLC
  • Facility Address: 1585 SW MARLOW AVE #220
    PORTLAND, OR
    ZIP 97225
  • Facility Phone: 503 704-6726
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: POONAM WALIA CHHIBBER
  • NPI Number: 1225838071
  • Taxonomy: 207QB0002X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D2327730
LAB Type Physician Office
Facility Name ELITE PRIMARY CARE LLC
Street 1585 SW MARLOW AVE #220
City PORTLAND
State OR
ZIP 97225
Phone 503 704-6726
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2025
Certificate Expiration Date 7/27/2027
Facility Type Physician Office
Lab Director POONAM WALIA CHHIBBER

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