38D2108343 CLIA NUMBER - DESCHUTES SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 38D2108343
  • Facility Name: DESCHUTES SURGERY CENTER
  • Facility Address: 2115 NE WYATT COURT, SUITE 105
    BEND, OR
    ZIP 97701
  • Facility Phone: 541 323-6280
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. PHILIP C. WALLACE MD
  • NPI Number: 1023056017
  • Taxonomy: 261QP0905X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2108343
LAB Type Ambulatory Surgery Center
Facility Name DESCHUTES SURGERY CENTER
Street 2115 NE WYATT COURT, SUITE 105
City BEND
State OR
ZIP 97701
Phone 541 323-6280
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2024
Certificate Expiration Date 2/1/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. PHILIP C. WALLACE MD

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