38D2003753 CLIA NUMBER - SAMARITAN UROLOGY CORVALLIS

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Laboratory Demographics

CLIA Number: 38D2003753

Facility Name: SAMARITAN UROLOGY CORVALLIS

Facility Address:
990 NW CIRCLE BLVD STE 102
CORVALLIS, OR
ZIP 97330
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Facility Phone Number: 541 768-5486

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1235409236

Taxonomy: 208800000X - Urology
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

CLIA Record

Field Name	Field Value
CLIA Number	38D2003753
LAB Type	Physician Office
Facility Name	SAMARITAN UROLOGY CORVALLIS
Street	990 NW CIRCLE BLVD STE 102
City	CORVALLIS
State	OR
ZIP	97330
Phone	541 768-5486
CertificateType	4
CertificateEffectiveDate	3/23/2024
CertificateExpirationDate	3/22/2026
FacilityType	Waiver

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