38D1095453 CLIA NUMBER - COLUMBIA GORGE SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 38D1095453
  • Facility Name: COLUMBIA GORGE SURGERY CENTER LLC
  • Facility Address: 1020 WEBBER STREET
    THE DALLES, OR
    ZIP 97058
  • Facility Phone: (541) 769-0426
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: GREG STANLEY
  • NPI Number: 1386898435
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D1095453
LAB Type Ambulatory Surgery Center
Facility Name COLUMBIA GORGE SURGERY CENTER LLC
Street 1020 WEBBER STREET
City THE DALLES
State OR
ZIP 97058
Phone 5417690426
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2025
Certificate Expiration Date 2/8/2027
Facility Type Ambulatory Surgery Center
Lab Director GREG STANLEY

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This page was last updated on: 5/18/2026