38D1006089 CLIA NUMBER - FALL CREEK INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 38D1006089
  • Facility Name: FALL CREEK INTERNAL MEDICINE
  • Facility Address: 2160 NE WILLIAMSON COURT
    BEND, OR
    ZIP 97701
  • Facility Phone: 541 389-1118
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PATRICIA NIBLER MD
  • NPI Number: 1518005222
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D1006089
LAB Type Physician Office
Facility Name FALL CREEK INTERNAL MEDICINE
Street 2160 NE WILLIAMSON COURT
City BEND
State OR
ZIP 97701
Phone 541 389-1118
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2024
Certificate Expiration Date 11/5/2026
Facility Type Physician Office
Lab Director DR. PATRICIA NIBLER MD

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