38D2057682 CLIA NUMBER - HARRISON FAMILY MEDICINE

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Laboratory Demographics

CLIA Number: 38D2057682

Facility Name: HARRISON FAMILY MEDICINE

Facility Address:
1100 SOUTHGATE SUITE 2
PENDLETON, OR
ZIP 97801
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Facility Phone Number: 541 215-1564

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1154764405

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D2057682
LAB Type	Physician Office
Facility Name	HARRISON FAMILY MEDICINE
Street	1100 SOUTHGATE SUITE 2
City	PENDLETON
State	OR
ZIP	97801
Phone	541 215-1564
CertificateType	4
CertificateEffectiveDate	4/22/2023
CertificateExpirationDate	4/21/2025
FacilityType	Waiver

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