38D2063124 CLIA NUMBER - EMURGENT CARE, LLC

Laboratory Demographics

  • CLIA Code: 38D2063124
  • Facility Name: EMURGENT CARE, LLC
  • Facility Address: 109 B E ELLENDALE AVE
    DALLAS, OR
    ZIP 97338
  • Facility Phone: 503 623-3199
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: CRYSTAL H. KOHISTANI
  • NPI Number: 1265871123
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2063124
LAB Type Other - URGENT CARE
Facility Name EMURGENT CARE, LLC
Street 109 B E ELLENDALE AVE
City DALLAS
State OR
ZIP 97338
Phone 503 623-3199
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2025
Certificate Expiration Date 1/8/2027
Facility Type Other - URGENT CARE
Lab Director CRYSTAL H. KOHISTANI

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