38D2142119 CLIA NUMBER - SOUTH WEST INTERNAL MEDICINE LLC

Laboratory Demographics

  • CLIA Code: 38D2142119
  • Facility Name: SOUTH WEST INTERNAL MEDICINE LLC
  • Facility Address: 940 EAST 5TH ST
    COQUILLE, OR
    ZIP 97423
  • Facility Phone: (541) 396-3111
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DOUGLAS G. CRANE
  • NPI Number: 1497203194
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 38D2142119
LAB Type Physician Office
Facility Name SOUTH WEST INTERNAL MEDICINE LLC
Street 940 EAST 5TH ST
City COQUILLE
State OR
ZIP 97423
Phone 5413963111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2026
Certificate Expiration Date 1/2/2028
Facility Type Physician Office
Lab Director DR. DOUGLAS G. CRANE

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This page was last updated on: 6/29/2026