38D2203731 CLIA NUMBER - CANYON CREEK CLINIC

Laboratory Demographics

  • CLIA Code: 38D2203731
  • Facility Name: CANYON CREEK CLINIC
  • Facility Address: 235 S CANYON BLVD
    JOHN DAY, OR
    ZIP 97845
  • Facility Phone: 541 575-1263
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SHAWNA A. CLARK
  • NPI Number: 1356952048
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2203731
LAB Type Physician Office
Facility Name CANYON CREEK CLINIC
Street 235 S CANYON BLVD
City JOHN DAY
State OR
ZIP 97845
Phone 541 575-1263
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/4/2024
Certificate Expiration Date 12/3/2026
Facility Type Physician Office
Lab Director SHAWNA A. CLARK

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