38D2162885 CLIA NUMBER - UNITED COMMUNITY ACTION NETWORK WIC PROGRAM

Laboratory Demographics

  • CLIA Code: 38D2162885
  • Facility Name: UNITED COMMUNITY ACTION NETWORK WIC PROGRAM
  • Facility Address: 280 KENNETH FORD DR
    ROSEBURG, OR
    ZIP 97470
  • Facility Phone: 541 440-3516
  • Facility Type: Other - WIC PROGRAM
  • Facility Type: Waiver
  • Lab Director: WENDY M. OSINCUP
  • NPI Number: 1487070181
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 38D2162885
LAB Type Other - WIC PROGRAM
Facility Name UNITED COMMUNITY ACTION NETWORK WIC PROGRAM
Street 280 KENNETH FORD DR
City ROSEBURG
State OR
ZIP 97470
Phone 541 440-3516
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2025
Certificate Expiration Date 3/3/2027
Facility Type Other - WIC PROGRAM
Lab Director WENDY M. OSINCUP

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