38D1085810 CLIA NUMBER - CENTRAL OREGON DERMATOLOGY PC

Laboratory Demographics

CLIA Number: 38D1085810

Facility Name: CENTRAL OREGON DERMATOLOGY PC

Facility Address:
388 SW BLUFF DRIVE
BEND, OR
ZIP 97702
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Facility Phone Number: 541 678-0020

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1760861835

Taxonomy: 261QE0800X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D1085810
LAB Type	Physician Office
Facility Name	CENTRAL OREGON DERMATOLOGY PC
Street	388 SW BLUFF DRIVE
City	BEND
State	OR
ZIP	97702
Phone	541 678-0020
CertificateType	2
CertificateEffectiveDate	9/25/2022
CertificateExpirationDate	9/24/2024
FacilityType	Compliance

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This page was last updated on: 4/23/2024