38D0976299 CLIA NUMBER - JORDAN VALLEY AMBULANCE SEVC

Laboratory Demographics

  • CLIA Code: 38D0976299
  • Facility Name: JORDAN VALLEY AMBULANCE SEVC
  • Facility Address: 306 BLACKABY ST
    JORDAN VALLEY, OR
    ZIP 97910
  • Facility Phone: 541 586-2820
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: RUSSELL MARTIN
  • NPI Number: 1447312004
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 38D0976299
LAB Type Ambulance
Facility Name JORDAN VALLEY AMBULANCE SEVC
Street 306 BLACKABY ST
City JORDAN VALLEY
State OR
ZIP 97910
Phone 541 586-2820
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type Ambulance
Lab Director RUSSELL MARTIN

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