38D0626322 CLIA NUMBER - LEGACY MEDICAL GROUP SILVERTON FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 38D0626322
  • Facility Name: LEGACY MEDICAL GROUP SILVERTON FAMILY MEDICINE
  • Facility Address: 335 FAIRVIEW ST
    SILVERTON, OR
    ZIP 97381
  • Facility Phone: 503 874-5653
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ELIZABETH J. BLOUNT
  • NPI Number: 1619997418
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D0626322
LAB Type Physician Office
Facility Name LEGACY MEDICAL GROUP SILVERTON FAMILY MEDICINE
Street 335 FAIRVIEW ST
City SILVERTON
State OR
ZIP 97381
Phone 503 874-5653
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 9/26/2024
Certificate Expiration Date 9/25/2026
Facility Type Physician Office
Lab Director ELIZABETH J. BLOUNT

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