38D0856305 CLIA NUMBER - FOUR RIVERS DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 38D0856305
  • Facility Name: FOUR RIVERS DIALYSIS CENTER
  • Facility Address: 515 EAST LANE
    ONTARIO, OR
    ZIP 97914
  • Facility Phone: 541 889-9557
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MICHAEL J. ADCOX MD
  • NPI Number: 1053363689
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D0856305
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FOUR RIVERS DIALYSIS CENTER
Street 515 EAST LANE
City ONTARIO
State OR
ZIP 97914
Phone 541 889-9557
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 End Stage Renal Disease Dialysis Facility
Lab Director MICHAEL J. ADCOX MD

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