38D1060799 CLIA NUMBER - GORGE UROLOGY

Laboratory Demographics

  • CLIA Code: 38D1060799
  • Facility Name: GORGE UROLOGY
  • Facility Address: 1805 E 19TH ST
    THE DALLES, OR
    ZIP 97058
  • Facility Phone: 541 296-7214
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GARY A. GINGRICH
  • NPI Number: 1487823944
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 38D1060799
LAB Type Physician Office
Facility Name GORGE UROLOGY
Street 1805 E 19TH ST
City THE DALLES
State OR
ZIP 97058
Phone 541 296-7214
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2025
Certificate Expiration Date 1/23/2027
Facility Type Physician Office
Lab Director GARY A. GINGRICH

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