38D1016124 CLIA NUMBER - SOUTHERN OREGON GYNECOLOGY

Laboratory Demographics

  • CLIA Code: 38D1016124
  • Facility Name: SOUTHERN OREGON GYNECOLOGY
  • Facility Address: 1910 E BARNETT RD STE 102
    MEDFORD, OR
    ZIP 97504
  • Facility Phone: 541 500-4747
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LORETTA SANDOVALL
  • NPI Number: 1225091226
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 38D1016124
LAB Type Physician Office
Facility Name SOUTHERN OREGON GYNECOLOGY
Street 1910 E BARNETT RD STE 102
City MEDFORD
State OR
ZIP 97504
Phone 541 500-4747
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/12/2024
Certificate Expiration Date 3/11/2026
Facility Type Physician Office
Lab Director LORETTA SANDOVALL

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