38D0953442 CLIA NUMBER - NORTHWEST UROLOGY LLC

Laboratory Demographics

  • CLIA Code: 38D0953442
  • Facility Name: NORTHWEST UROLOGY LLC
  • Facility Address: 2435 NE CUMULUS AVE SUITE E
    MCMINNVILLE, OR
    ZIP 97128
  • Facility Phone: 503 223-6223
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DAVID A. STANECK
  • NPI Number: 1629461397
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 38D0953442
LAB Type Physician Office
Facility Name NORTHWEST UROLOGY LLC
Street 2435 NE CUMULUS AVE SUITE E
City MCMINNVILLE
State OR
ZIP 97128
Phone 503 223-6223
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 DAVID A. STANECK

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This page was last updated on: 3/20/2025