38D2214216 CLIA NUMBER - ADAPT-DETOX

Laboratory Demographics

  • CLIA Code: 38D2214216
  • Facility Name: ADAPT-DETOX
  • Facility Address: 3099 NE DIAMOND LAKE BLVD
    ROSEBURG, OR
    ZIP 97470
  • Facility Phone: 541 492-0506
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: THERESA M. LUNDY
  • NPI Number: 1154502052
  • Taxonomy: 101YA0400X - Counselor

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 38D2214216
LAB Type Comp. Outpatient Rehab Facility
Facility Name ADAPT-DETOX
Street 3099 NE DIAMOND LAKE BLVD
City ROSEBURG
State OR
ZIP 97470
Phone 541 492-0506
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2025
Certificate Expiration Date 2/18/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director THERESA M. LUNDY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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