38D0867765 CLIA NUMBER - UMPQUA COMMUNITY HEALTH INC (DBA AVIVA HEALTH)-ROSEBURG

Laboratory Demographics

  • CLIA Code: 38D0867765
  • Facility Name: UMPQUA COMMUNITY HEALTH INC (DBA AVIVA HEALTH)-ROSEBURG
  • Facility Address: 150 KENNETH FORD DR
    ROSEBURG, OR
    ZIP 97470
  • Facility Phone: 541 672-9596
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: JAY J. RICHARDS
  • NPI Number: 1396751772
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D0867765
LAB Type Federally Qualified Health Center
Facility Name UMPQUA COMMUNITY HEALTH INC (DBA AVIVA HEALTH)-ROSEBURG
Street 150 KENNETH FORD DR
City ROSEBURG
State OR
ZIP 97470
Phone 541 672-9596
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 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type Federally Qualified Health Center
Lab Director JAY J. RICHARDS

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This page was last updated on: 6/4/2025