38D2010591 CLIA NUMBER - PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL MTN CLINIC

Laboratory Demographics

  • CLIA Code: 38D2010591
  • Facility Name: PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL MTN CLINIC
  • Facility Address: 14040 HIGHWAY 35
    MT HOOD, OR
    ZIP 97041
  • Facility Phone: 541 387-6501
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL MURRAY
  • NPI Number: 1437355955
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2010591
LAB Type Ancillary Testing Site in Health Care Center
Facility Name PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL MTN CLINIC
Street 14040 HIGHWAY 35
City MT HOOD
State OR
ZIP 97041
Phone 541 387-6501
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2024
Certificate Expiration Date 7/29/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director DR. MICHAEL MURRAY

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This page was last updated on: 3/20/2025