20D0089098 CLIA NUMBER - EMERALD WELLNESS PC EMERALD VALLEY WELLNESS CLINIC

Laboratory Demographics

  • CLIA Code: 20D0089098
  • Facility Name: EMERALD WELLNESS PC EMERALD VALLEY WELLNESS CLINIC
  • Facility Address: 300 N MILL ST SUITE A
    CRESWELL, OR
    ZIP 97426
  • Facility Phone: 541 895-5300
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RICHARD A. HANSEN MD
  • NPI Number: 1184833139
  • Taxonomy: 208D00000X - General Practice

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 20D0089098
LAB Type Physician Office
Facility Name EMERALD WELLNESS PC EMERALD VALLEY WELLNESS CLINIC
Street 300 N MILL ST SUITE A
City CRESWELL
State OR
ZIP 97426
Phone 541 895-5300
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director RICHARD A. HANSEN MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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