38D2010555 CLIA NUMBER - SANTIAM WOMENS CLINIC

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Laboratory Demographics

CLIA Number: 38D2010555

Facility Name: SANTIAM WOMENS CLINIC

Facility Address:
1373 N 10TH AVE
STAYTON, OR
ZIP 97383
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Facility Phone Number: 503 769-9522

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1063731271

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	38D2010555
LAB Type	Community Clinic
Facility Name	SANTIAM WOMENS CLINIC
Street	1373 N 10TH AVE
City	STAYTON
State	OR
ZIP	97383
Phone	503 769-9522
CertificateType	4
CertificateEffectiveDate	7/29/2022
CertificateExpirationDate	7/28/2024
FacilityType	Waiver

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