38D2176821 CLIA NUMBER - RIVER ROCK FAMILY PRACTICE, PC

Laboratory Demographics

  • CLIA Code: 38D2176821
  • Facility Name: RIVER ROCK FAMILY PRACTICE, PC
  • Facility Address: 3144 STATE STREET
    MEDFORD, OR
    ZIP 97504
  • Facility Phone: 541 226-9840
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MASON C. HARRISON
  • NPI Number: 1053957225
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 38D2176821
LAB Type Practitioner Other
Facility Name RIVER ROCK FAMILY PRACTICE, PC
Street 3144 STATE STREET
City MEDFORD
State OR
ZIP 97504
Phone 541 226-9840
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/26/2023
Certificate Expiration Date 12/25/2025
Facility Type Practitioner Other
Lab Director MASON C. HARRISON

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