38D0940524 CLIA NUMBER - STARK MEDICAL GROUP PC

Laboratory Demographics

  • CLIA Code: 38D0940524
  • Facility Name: STARK MEDICAL GROUP PC
  • Facility Address: 932 W IDAHO AVE SUITE 100
    ONTARIO, OR
    ZIP 97914
  • Facility Phone: 541 889-2244
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JODY A. STARK
  • NPI Number: 1063754208
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 38D0940524
LAB Type Physician Office
Facility Name STARK MEDICAL GROUP PC
Street 932 W IDAHO AVE SUITE 100
City ONTARIO
State OR
ZIP 97914
Phone 541 889-2244
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 Physician Office
Lab Director JODY A. STARK

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