38D2171423 CLIA NUMBER - NORTHWEST FAMILY PRACTICE, LLC

Laboratory Demographics

  • CLIA Code: 38D2171423
  • Facility Name: NORTHWEST FAMILY PRACTICE, LLC
  • Facility Address: 1619 NW HAWTHORNE AVE, SUITE 101
    GRANTS PASS, OR
    ZIP 97526
  • Facility Phone: 541 916-5500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GAIL GILTNER
  • NPI Number: 1891347415
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 38D2171423
LAB Type Physician Office
Facility Name NORTHWEST FAMILY PRACTICE, LLC
Street 1619 NW HAWTHORNE AVE, SUITE 101
City GRANTS PASS
State OR
ZIP 97526
Phone 541 916-5500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Physician Office
Lab Director GAIL GILTNER

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