38D1087295 CLIA NUMBER - WILLAMETTE VALLEY HOSPICE

Laboratory Demographics

  • CLIA Code: 38D1087295
  • Facility Name: WILLAMETTE VALLEY HOSPICE
  • Facility Address: 1015 3RD ST NW
    SALEM, OR
    ZIP 97304
  • Facility Phone: 503 588-3600
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: NANCY BOUTIN MD
  • NPI Number: 1093715070
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 38D1087295
LAB Type Hospice
Facility Name WILLAMETTE VALLEY HOSPICE
Street 1015 3RD ST NW
City SALEM
State OR
ZIP 97304
Phone 503 588-3600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Hospice
Lab Director NANCY BOUTIN MD

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