38D0628508 CLIA NUMBER - PEDIATRIC SPECIALISTS OF PENDLETON LABORATORY

Laboratory Demographics

  • CLIA Code: 38D0628508
  • Facility Name: PEDIATRIC SPECIALISTS OF PENDLETON LABORATORY
  • Facility Address: 2461 SW PERKINS AVE
    PENDLETON, OR
    ZIP 97801
  • Facility Phone: 541 276-0250
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RHONDA L WYLAND MD
  • NPI Number: 1689739310
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D0628508
LAB Type Physician Office
Facility Name PEDIATRIC SPECIALISTS OF PENDLETON LABORATORY
Street 2461 SW PERKINS AVE
City PENDLETON
State OR
ZIP 97801
Phone 541 276-0250
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 RHONDA L WYLAND MD

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