38D0988134 CLIA NUMBER - NORTH BEND CBOC

Laboratory Demographics

  • CLIA Code: 38D0988134
  • Facility Name: NORTH BEND CBOC
  • Facility Address: 2192 MARION AVENUE
    NORTH BEND, OR
    ZIP 97459
  • Facility Phone: 541 440-1000
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: MANI EHTESHAMI
  • NPI Number: 1790884054
  • Taxonomy: 332000000X - Military/U.S. Coast Guard Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D0988134
LAB Type Community Clinic
Facility Name NORTH BEND CBOC
Street 2192 MARION AVENUE
City NORTH BEND
State OR
ZIP 97459
Phone 541 440-1000
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 6/21/2001
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director MANI EHTESHAMI

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