38D1001339 CLIA NUMBER - MOSAIC-PRINEVILLE HEALTH CENTER

Laboratory Demographics

CLIA Number: 38D1001339

Facility Name: MOSAIC-PRINEVILLE HEALTH CENTER

Facility Address:
375 NW BEAVER ST, SUITE 101
PRINEVILLE, OR
ZIP 97754
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Facility Phone Number: 541 383-3005

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1023523073

Taxonomy: 261QF0400X - Clinic/Center

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
CertificateType	3
CertificateEffectiveDate	9/3/2022
CertificateExpirationDate	9/2/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024