38D2146974 CLIA NUMBER - SANTIAM MOBILE MEDICINE

Laboratory Demographics

  • CLIA Code: 38D2146974
  • Facility Name: SANTIAM MOBILE MEDICINE
  • Facility Address: 41805 STAYTON SCIO RD SE
    STAYTON, OR
    ZIP 97383
  • Facility Phone: 503 507-5356
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: CASEY LULAY
  • NPI Number: 1750899035
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 38D2146974
LAB Type Mobile Laboratory
Facility Name SANTIAM MOBILE MEDICINE
Street 41805 STAYTON SCIO RD SE
City STAYTON
State OR
ZIP 97383
Phone 503 507-5356
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2024
Certificate Expiration Date 4/9/2026
Facility Type Mobile Laboratory
Lab Director CASEY LULAY

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