38D1101174 CLIA NUMBER - BSM SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 38D1101174
  • Facility Name: BSM SURGERY CENTER LLC
  • Facility Address: 1128 NE 2ND ST SUITE 104
    CORVALLIS, OR
    ZIP 97330
  • Facility Phone: 541 207-3334
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: RONALD WOBIG MD
  • NPI Number: 1689800666
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D1101174
LAB Type Ambulance
Facility Name BSM SURGERY CENTER LLC
Street 1128 NE 2ND ST SUITE 104
City CORVALLIS
State OR
ZIP 97330
Phone 541 207-3334
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2025
Certificate Expiration Date 6/21/2027
Facility Type Ambulance
Lab Director RONALD WOBIG MD

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