38D1048209 CLIA NUMBER - CALDERA FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 38D1048209
  • Facility Name: CALDERA FAMILY MEDICINE
  • Facility Address: 2564 NE COURTNEY DRIVE
    BEND, OR
    ZIP 97701
  • Facility Phone: 541 678-5277
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: BRIANNE KANEHL
  • NPI Number: 1700106986
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D1048209
LAB Type Practitioner Other
Facility Name CALDERA FAMILY MEDICINE
Street 2564 NE COURTNEY DRIVE
City BEND
State OR
ZIP 97701
Phone 541 678-5277
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 10/1/2024
Certificate Expiration Date 9/30/2026
Facility Type Practitioner Other
Lab Director BRIANNE KANEHL

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