38D0628393 CLIA NUMBER - MADRAS MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 38D0628393
  • Facility Name: MADRAS MEDICAL GROUP
  • Facility Address: 76 NE 12TH ST
    MADRAS, OR
    ZIP 97741
  • Facility Phone: 541 475-3874
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: THOMAS M. MANNING MD
  • NPI Number: 1093768533
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D0628393
LAB Type Physician Office
Facility Name MADRAS MEDICAL GROUP
Street 76 NE 12TH ST
City MADRAS
State OR
ZIP 97741
Phone 541 475-3874
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 1/1/2024
Certificate Expiration Date 12/31/2025
Facility Type Physician Office
Lab Director THOMAS M. MANNING MD

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