38D2153754 CLIA NUMBER - GRANDE RONDE THERAPY

Laboratory Demographics

  • CLIA Code: 38D2153754
  • Facility Name: GRANDE RONDE THERAPY
  • Facility Address: 610 SUNSET DRIVE
    LA GRANDE, OR
    ZIP 97850
  • Facility Phone: 541 963-1437
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: NICOLE TURNER MD
  • NPI Number: 1497807812
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D2153754
LAB Type Ancillary Testing Site in Health Care Center
Facility Name GRANDE RONDE THERAPY
Street 610 SUNSET DRIVE
City LA GRANDE
State OR
ZIP 97850
Phone 541 963-1437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2024
Certificate Expiration Date 8/28/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director NICOLE TURNER MD

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This page was last updated on: 6/4/2025