38D1002050 CLIA NUMBER - MY MD PERSONAL MEDICINE

Laboratory Demographics

  • CLIA Code: 38D1002050
  • Facility Name: MY MD PERSONAL MEDICINE
  • Facility Address: 695 NW YORK DRIVE, SUITE 100
    BEND, OR
    ZIP 97703
  • Facility Phone: 541 322-6869
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RICHARD MACDONELL
  • NPI Number: 1649334285
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D1002050
LAB Type Physician Office
Facility Name MY MD PERSONAL MEDICINE
Street 695 NW YORK DRIVE, SUITE 100
City BEND
State OR
ZIP 97703
Phone 541 322-6869
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/26/2024
Certificate Expiration Date 7/25/2026
Facility Type Physician Office
Lab Director DR. RICHARD MACDONELL

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