38D2108343 CLIA NUMBER - DESCHUTES SURGERY CENTER

Laboratory Demographics

CLIA Number: 38D2108343

Facility Name: DESCHUTES SURGERY CENTER

Facility Address:
2115 NE WYATT COURT, SUITE 105
BEND, OR
ZIP 97701
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Facility Phone Number: 541 323-6280

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1023056017

Taxonomy: 261QP0905X - Clinic/Center

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
CertificateType	4
CertificateEffectiveDate	2/2/2024
CertificateExpirationDate	2/1/2026
FacilityType	Waiver

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