38D2149799 CLIA NUMBER - COLUMBIACARE SERVICES OUTPATIENT CLINIC

Laboratory Demographics

  • CLIA Code: 38D2149799
  • Facility Name: COLUMBIACARE SERVICES OUTPATIENT CLINIC
  • Facility Address: 503 AIRPORT ROAD, SUITE 101
    MEDFORD, OR
    ZIP 97504
  • Facility Phone: 541 200-2900
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: RANDI M. GRUESSING
  • NPI Number: 1861942096
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2149799
LAB Type Community Clinic
Facility Name COLUMBIACARE SERVICES OUTPATIENT CLINIC
Street 503 AIRPORT ROAD, SUITE 101
City MEDFORD
State OR
ZIP 97504
Phone 541 200-2900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type Community Clinic
Lab Director RANDI M. GRUESSING

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