38D0978396 CLIA NUMBER - KENNETH WHITTAKER MD CHILDREN'S MEDICAL CLINIC OF NEWBERG

Laboratory Demographics

  • CLIA Code: 38D0978396
  • Facility Name: KENNETH WHITTAKER MD CHILDREN'S MEDICAL CLINIC OF NEWBERG
  • Facility Address: 506 VILLA ROAD
    NEWBERG, OR
    ZIP 97132
  • Facility Phone: 503 554-0036
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENNETH A. WHITTAKER MD
  • NPI Number: 1073606687
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 38D0978396
LAB Type Physician Office
Facility Name KENNETH WHITTAKER MD CHILDREN'S MEDICAL CLINIC OF NEWBERG
Street 506 VILLA ROAD
City NEWBERG
State OR
ZIP 97132
Phone 503 554-0036
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2024
Certificate Expiration Date 9/21/2026
Facility Type Physician Office
Lab Director KENNETH A. WHITTAKER MD

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