38D1054074 CLIA NUMBER - FIRST AVENUE CLINIC

Laboratory Demographics

  • CLIA Code: 38D1054074
  • Facility Name: FIRST AVENUE CLINIC
  • Facility Address: 322 NW 1ST AVE
    CANBY, OR
    ZIP 97013
  • Facility Phone: 503 266-2000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DIANN L. FREASE ND
  • NPI Number: 1710173190
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D1054074
LAB Type Physician Office
Facility Name FIRST AVENUE CLINIC
Street 322 NW 1ST AVE
City CANBY
State OR
ZIP 97013
Phone 503 266-2000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2024
Certificate Expiration Date 5/9/2026
Facility Type Physician Office
Lab Director DIANN L. FREASE ND

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