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38D1002050 CLIA NUMBER - MY MD PERSONAL MEDICINE

Laboratory Demographics

CLIA Number: 38D1002050

Facility Name: MY MD PERSONAL MEDICINE

Facility Address:
695 NW YORK DRIVE, SUITE 100
BEND, OR
ZIP 97703
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Facility Phone Number: 541 322-6869

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1649334285

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

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
CertificateType 4
CertificateEffectiveDate 7/26/2022
CertificateExpirationDate 7/25/2024
FacilityType Waiver

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