38D1077910 CLIA NUMBER - OREGON ADVANCED IMAGING

Laboratory Demographics

  • CLIA Code: 38D1077910
  • Facility Name: OREGON ADVANCED IMAGING
  • Facility Address: 1107 CRATER LAKE AVENUE
    MEDFORD, OR
    ZIP 97504
  • Facility Phone: 541 608-0350
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: MR. TYRONE HOLMES
  • NPI Number: 1083688402
  • Taxonomy: 2471M1202X - Radiologic Technologist

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CLIA Record

Field Name Field Value
CLIA Number 38D1077910
LAB Type Other
Facility Name OREGON ADVANCED IMAGING
Street 1107 CRATER LAKE AVENUE
City MEDFORD
State OR
ZIP 97504
Phone 541 608-0350
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Other
Lab Director MR. TYRONE HOLMES

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