38D2140976 CLIA NUMBER - MID ROGUE IMAGING

Laboratory Demographics

  • CLIA Code: 38D2140976
  • Facility Name: MID ROGUE IMAGING
  • Facility Address: 1619 NW HAWTHORNE AVENUE, SUITE 102
    GRANTS PASS, OR
    ZIP 97526
  • Facility Phone: 541 472-5154
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: THOMAS G. JONES
  • NPI Number: 1952730871
  • Taxonomy: 261QR0200X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 38D2140976
LAB Type Ancillary Testing Site in Health Care Center
Facility Name MID ROGUE IMAGING
Street 1619 NW HAWTHORNE AVENUE, SUITE 102
City GRANTS PASS
State OR
ZIP 97526
Phone 541 472-5154
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/5/2023
Certificate Expiration Date 12/4/2025
Facility Type Ancillary Testing Site in Health Care Center
Lab Director THOMAS G. JONES

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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