38D2040075 CLIA NUMBER - COLUMBIA RIVER SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 38D2040075
  • Facility Name: COLUMBIA RIVER SURGERY CENTER LLC
  • Facility Address: 9820 NE CASCADES PKWY
    PORTLAND, OR
    ZIP 97220
  • Facility Phone: 503 284-4147
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARC DAVIDSON MD
  • NPI Number: 1780959007
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2040075
LAB Type Ambulatory Surgery Center
Facility Name COLUMBIA RIVER SURGERY CENTER LLC
Street 9820 NE CASCADES PKWY
City PORTLAND
State OR
ZIP 97220
Phone 503 284-4147
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2024
Certificate Expiration Date 4/22/2026
Facility Type Ambulatory Surgery Center
Lab Director MARC DAVIDSON MD

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This page was last updated on: 6/4/2025