Healthcare Provider Details

I. General information

NPI: 1275161671
Provider Name (Legal Business Name): SOFT CELL L-FORM LABORATORIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 NE STUCKI AVE STE 100
HILLSBORO OR
97006-6951
US

IV. Provider business mailing address

1915 NE STUCKI AVE STE 100
HILLSBORO OR
97006-6951
US

V. Phone/Fax

Practice location:
  • Phone: 503-402-2505
  • Fax: 435-990-7242
Mailing address:
  • Phone: 503-402-2505
  • Fax: 435-990-7242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ROEL CHAVEZ
Title or Position: OWNER
Credential:
Phone: 435-525-1721