38D2063701 CLIA NUMBER - MOSAIC-CROOK KIDS SCHOOL-BASED HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 38D2063701
  • Facility Name: MOSAIC-CROOK KIDS SCHOOL-BASED HEALTH CENTER
  • Facility Address: 757 NE 1ST STREET
    PRINEVILLE, OR
    ZIP 97754
  • Facility Phone: 541 383-3005
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DIANA BURDEN
  • NPI Number: 1467090183
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2063701
LAB Type Federally Qualified Health Center
Facility Name MOSAIC-CROOK KIDS SCHOOL-BASED HEALTH CENTER
Street 757 NE 1ST STREET
City PRINEVILLE
State OR
ZIP 97754
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 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Federally Qualified Health Center
Lab Director DIANA BURDEN

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