38D0903690 CLIA NUMBER - PEACEHEALTH MEDICAL GROUP - 390

Laboratory Demographics

  • CLIA Code: 38D0903690
  • Facility Name: PEACEHEALTH MEDICAL GROUP - 390
  • Facility Address: 380 9TH STREET
    FLORENCE, OR
    ZIP 97439
  • Facility Phone: 541 902-6140
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW BZDEGA
  • NPI Number: 1811908668
  • Taxonomy: 3336C0002X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D0903690
LAB Type Physician Office
Facility Name PEACEHEALTH MEDICAL GROUP - 390
Street 380 9TH STREET
City FLORENCE
State OR
ZIP 97439
Phone 541 902-6140
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Physician Office
Lab Director MATTHEW BZDEGA

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