38D2206793 CLIA NUMBER - BEAR VALLEY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 38D2206793
  • Facility Name: BEAR VALLEY MEDICAL CLINIC
  • Facility Address: 1690 NE LYNDA LANE
    GRANTS PASS, OR
    ZIP 97526
  • Facility Phone: 541 237-5040
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DANIEL TIBBITS
  • NPI Number: 1780287342
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 38D2206793
LAB Type Practitioner Other
Facility Name BEAR VALLEY MEDICAL CLINIC
Street 1690 NE LYNDA LANE
City GRANTS PASS
State OR
ZIP 97526
Phone 541 237-5040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2024
Certificate Expiration Date 12/21/2026
Facility Type Practitioner Other
Lab Director DANIEL TIBBITS

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