38D2191333 CLIA NUMBER - ADVANTAGE DENTAL + BOARDMAN

Laboratory Demographics

  • CLIA Code: 38D2191333
  • Facility Name: ADVANTAGE DENTAL + BOARDMAN
  • Facility Address: 300 TATONE
    BOARDMAN, OR
    ZIP 97818
  • Facility Phone: 541 837-1663
  • Facility Type: Other - DENTAL
  • Facility Type: Waiver
  • Lab Director: GARY W. ALLEN
  • NPI Number: 1831741958
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 38D2191333
LAB Type Other - DENTAL
Facility Name ADVANTAGE DENTAL + BOARDMAN
Street 300 TATONE
City BOARDMAN
State OR
ZIP 97818
Phone 541 837-1663
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type Other - DENTAL
Lab Director GARY W. ALLEN

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