38D0622013 CLIA NUMBER - COLUMBIA GORGE FAMILY MEDICINE

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Laboratory Demographics

CLIA Number: 38D0622013

Facility Name: COLUMBIA GORGE FAMILY MEDICINE

Facility Address:
1750 12TH STREET
HOOD RIVER, OR
ZIP 97031
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Facility Phone Number: 541 386-5070

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1558346064

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	38D0622013
LAB Type	Physician Office
Facility Name	COLUMBIA GORGE FAMILY MEDICINE
Street	1750 12TH STREET
City	HOOD RIVER
State	OR
ZIP	97031
Phone	541 386-5070
CertificateType	3
CertificateEffectiveDate	1/1/2024
CertificateExpirationDate	12/31/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024