38D2057497 CLIA NUMBER - MOSAIC-REDMOND

Laboratory Demographics

  • CLIA Code: 38D2057497
  • Facility Name: MOSAIC-REDMOND
  • Facility Address: 1250 SW VETERANS WAY SUITE 120
    REDMOND, OR
    ZIP 97756
  • Facility Phone: 541 383-3005
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: BRIAN J. SULLIVAN
  • NPI Number: 1578801924
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2057497
LAB Type Federally Qualified Health Center
Facility Name MOSAIC-REDMOND
Street 1250 SW VETERANS WAY SUITE 120
City REDMOND
State OR
ZIP 97756
Phone 541 383-3005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Federally Qualified Health Center
Lab Director BRIAN J. SULLIVAN

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