38D1051934 CLIA NUMBER - GRANTS PASS PEDIATRICS

Laboratory Demographics

  • CLIA Code: 38D1051934
  • Facility Name: GRANTS PASS PEDIATRICS
  • Facility Address: 1601 NE 6TH ST
    GRANTS PASS, OR
    ZIP 97526
  • Facility Phone: 541 472-0021
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MS. LISA CALLAHAN CPNP
  • NPI Number: 1588739130
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D1051934
LAB Type Practitioner Other
Facility Name GRANTS PASS PEDIATRICS
Street 1601 NE 6TH ST
City GRANTS PASS
State OR
ZIP 97526
Phone 541 472-0021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2024
Certificate Expiration Date 3/13/2026
Facility Type Practitioner Other
Lab Director MS. LISA CALLAHAN CPNP

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