38D2115758 CLIA NUMBER - ST CHARLES ANTICOAGULATION CLINIC REDMOND

Laboratory Demographics

  • CLIA Code: 38D2115758
  • Facility Name: ST CHARLES ANTICOAGULATION CLINIC REDMOND
  • Facility Address: 655 NW JACKPINE AVENUE
    REDMOND, OR
    ZIP 97756
  • Facility Phone: 541 706-2913
  • Facility Type: Other - ANTI-COAG CLINIC
  • Facility Type: Waiver
  • Lab Director: KELLENE A. FISLER
  • NPI Number: 1295974491
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D2115758
LAB Type Other - ANTI-COAG CLINIC
Facility Name ST CHARLES ANTICOAGULATION CLINIC REDMOND
Street 655 NW JACKPINE AVENUE
City REDMOND
State OR
ZIP 97756
Phone 541 706-2913
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Other - ANTI-COAG CLINIC
Lab Director KELLENE A. FISLER

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