38D0910147 CLIA NUMBER - LA GRANDE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 38D0910147
  • Facility Name: LA GRANDE FAMILY MEDICINE
  • Facility Address: 2011 4TH ST
    LA GRANDE, OR
    ZIP 97850
  • Facility Phone: 541 963-4139
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRYAN CONKLIN
  • NPI Number: 1164451878
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 38D0910147
LAB Type Physician Office
Facility Name LA GRANDE FAMILY MEDICINE
Street 2011 4TH ST
City LA GRANDE
State OR
ZIP 97850
Phone 541 963-4139
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 1/1/2024
Certificate Expiration Date 12/31/2025
Facility Type Physician Office
Lab Director BRYAN CONKLIN

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