38D2194718 CLIA NUMBER - REDMOND ALF, LLC DBA BROOKSIDE PLACE

Laboratory Demographics

  • CLIA Code: 38D2194718
  • Facility Name: REDMOND ALF, LLC DBA BROOKSIDE PLACE
  • Facility Address: 3550 SW CANAL BLVD
    REDMOND, OR
    ZIP 97756
  • Facility Phone: 541 504-1600
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CHARLES DAVENPORT
  • NPI Number: 1922623206
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 38D2194718
LAB Type Assisted Living Facility
Facility Name REDMOND ALF, LLC DBA BROOKSIDE PLACE
Street 3550 SW CANAL BLVD
City REDMOND
State OR
ZIP 97756
Phone 541 504-1600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Assisted Living Facility
Lab Director CHARLES DAVENPORT

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