Organization
DK PATHOLOGY
Active
Organization
DK PATHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CLARK (MANAGER)
(503) 691-1122
Entity
Organization
Contact information
Practice address
6370 SW BORLAND RD, SUITE 206, TUALATIN, OR 97062-9768
(503) 691-1122
Mailing address
6370 SW BORLAND RD, SUITE 206, TUALATIN, OR 97062-9768
(503) 691-1122
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
38D2032723
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38D2032723
CLIA
OR
Enumeration date
12/13/2011
Last updated
12/13/2011
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