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Organization

UNIVERSITY PROFESSIONAL SERVICES

Active
Parent organization
OREGON HEALTH & SCIENCE UNIVERSITY
Other names
OHSU CEI Molecular Diagnostic Laboratory
Organization subpart
Yes

Provider details

NPI number
Legal business name
OREGON HEALTH & SCIENCE UNIVERSITY
Authorized official
DR. JOSEPH E ROBERTSON JR. MD, MBA (PRESIDENT, UNIVERSITY)
(503) 494-8133
Entity
Organization

Contact information

Practice address
3375 SW TERWILLIGER BLVD, MAIL CODE CEI, PORTLAND, OR 97239-4146
(503) 494-3000
(503) 494-0470
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE: CEI, PORTLAND, OR 97239-3011
(503) 494-8744

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
38D0623102
CLIA
OR
Enumeration date
07/27/2011
Last updated
07/27/2011
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