38D2051905 CLIA NUMBER - JUNIPER PEDIATRICS (DBA)

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Laboratory Demographics

CLIA Number: 38D2051905

Facility Name: JUNIPER PEDIATRICS (DBA)

Facility Address:
62930 OB RILEY RD, STE 300
BEND, OR
ZIP 97703
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Facility Phone Number: 541 323-5515

Facility Type: Practitioner Other

Certificate Type: Microscopy

NPI Number: 1053757666

Taxonomy: 332900000X - Non-Pharmacy Dispensing Site
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

CLIA Record

Field Name	Field Value
CLIA Number	38D2051905
LAB Type	Practitioner Other
Facility Name	JUNIPER PEDIATRICS (DBA)
Street	62930 OB RILEY RD, STE 300
City	BEND
State	OR
ZIP	97703
Phone	541 323-5515
CertificateType	3
CertificateEffectiveDate	1/2/2023
CertificateExpirationDate	1/1/2025
FacilityType	PPMP

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