50D1059651 CLIA NUMBER - PORTLAND VAMC - VANCOUVER CAMPUS

Laboratory Demographics

  • CLIA Code: 50D1059651
  • Facility Name: PORTLAND VAMC - VANCOUVER CAMPUS
  • Facility Address: 1601 EAST 4TH PLAIN BLVD
    VANCOUVER, WA
    ZIP 98661
  • Facility Phone: 360 696-4061
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: DEAN FONG
  • NPI Number: 1255424685
  • Taxonomy: 332100000X - Department of Veterans Affairs (VA) Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D1059651
LAB Type Community Clinic
Facility Name PORTLAND VAMC - VANCOUVER CAMPUS
Street 1601 EAST 4TH PLAIN BLVD
City VANCOUVER
State WA
ZIP 98661
Phone 360 696-4061
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 10/4/2006
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director DEAN FONG

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