38D0719574 CLIA NUMBER - PRIMARY CARE WEST LABORATORY

Laboratory Demographics

  • CLIA Code: 38D0719574
  • Facility Name: PRIMARY CARE WEST LABORATORY
  • Facility Address: 1255 WALLACE RD NW
    SALEM, OR
    ZIP 97304
  • Facility Phone: 503 362-1314
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LASLO E. KOLTA MD
  • NPI Number: 1407854243
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D0719574
LAB Type Physician Office
Facility Name PRIMARY CARE WEST LABORATORY
Street 1255 WALLACE RD NW
City SALEM
State OR
ZIP 97304
Phone 503 362-1314
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2024
Certificate Expiration Date 12/31/2025
Facility Type Physician Office
Lab Director LASLO E. KOLTA MD

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