38D0898617 CLIA NUMBER - NORTH LAKE COUNTY EMS LAB

Laboratory Demographics

  • CLIA Code: 38D0898617
  • Facility Name: NORTH LAKE COUNTY EMS LAB
  • Facility Address: PO BOX 423 CHRISTMAS VALLEY RD
    CHRISTMAS VALLEY, OR
    ZIP 97641
  • Facility Phone: 541 576-2758
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: SUE M INGALSBE
  • NPI Number: 1669607792
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D0898617
LAB Type Other
Facility Name NORTH LAKE COUNTY EMS LAB
Street PO BOX 423 CHRISTMAS VALLEY RD
City CHRISTMAS VALLEY
State OR
ZIP 97641
Phone 541 576-2758
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 Other
Lab Director SUE M INGALSBE

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