38D1001339 CLIA NUMBER - MOSAIC-PRINEVILLE HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 38D1001339
  • Facility Name: MOSAIC-PRINEVILLE HEALTH CENTER
  • Facility Address: 375 NW BEAVER ST, SUITE 101
    PRINEVILLE, OR
    ZIP 97754
  • Facility Phone: 541 383-3005
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DIANA BURDEN
  • NPI Number: 1023523073
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D1001339
LAB Type Federally Qualified Health Center
Facility Name MOSAIC-PRINEVILLE HEALTH CENTER
Street 375 NW BEAVER ST, SUITE 101
City PRINEVILLE
State OR
ZIP 97754
Phone 541 383-3005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2024
Certificate Expiration Date 9/2/2026
Facility Type Federally Qualified Health Center
Lab Director DIANA BURDEN

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