38D2107406 CLIA NUMBER - CANYONVILLE HEALTH AND URGENT CARE

Laboratory Demographics

  • CLIA Code: 38D2107406
  • Facility Name: CANYONVILLE HEALTH AND URGENT CARE
  • Facility Address: 115 S PINE STREET
    CANYONVILLE, OR
    ZIP 97417
  • Facility Phone: 541 839-4211
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANANDITA TIWARI MD
  • NPI Number: 1003210600
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D2107406
LAB Type Physician Office
Facility Name CANYONVILLE HEALTH AND URGENT CARE
Street 115 S PINE STREET
City CANYONVILLE
State OR
ZIP 97417
Phone 541 839-4211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/12/2024
Certificate Expiration Date 1/11/2026
Facility Type Physician Office
Lab Director ANANDITA TIWARI MD

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