38D2045176 CLIA NUMBER - DOCTORS PARK SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 38D2045176
  • Facility Name: DOCTORS PARK SURGERY CENTER LLC
  • Facility Address: 2090 NE WYATT COURT, SUITE 102
    BEND, OR
    ZIP 97701
  • Facility Phone: 541 389-5931
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ERIN HICKS
  • NPI Number: 1417906660
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2045176
LAB Type Ambulatory Surgery Center
Facility Name DOCTORS PARK SURGERY CENTER LLC
Street 2090 NE WYATT COURT, SUITE 102
City BEND
State OR
ZIP 97701
Phone 541 389-5931
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Ambulatory Surgery Center
Lab Director ERIN HICKS

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