38D0860602 CLIA NUMBER - PINE EAGLE CLINIC

Laboratory Demographics

  • CLIA Code: 38D0860602
  • Facility Name: PINE EAGLE CLINIC
  • Facility Address: 218 N PINE ST
    HALFWAY, OR
    ZIP 97834
  • Facility Phone: 541 742-5023
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DEAN N. DEFREES
  • NPI Number: 1922102128
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D0860602
LAB Type Rural Health Clinic
Facility Name PINE EAGLE CLINIC
Street 218 N PINE ST
City HALFWAY
State OR
ZIP 97834
Phone 541 742-5023
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2025
Certificate Expiration Date 9/20/2027
Facility Type Rural Health Clinic
Lab Director DEAN N. DEFREES

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