38D2263412 CLIA NUMBER - GRAHAM PEDIATRIC CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 38D2263412
  • Facility Name: GRAHAM PEDIATRIC CLINIC, LLC
  • Facility Address: 706 MAIN STREET, STE 2A
    KLAMATH FALLS, OR
    ZIP 97601
  • Facility Phone: 541 591-0877
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TRACY W. GRAHAM
  • NPI Number: 1174250104
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 38D2263412
LAB Type Physician Office
Facility Name GRAHAM PEDIATRIC CLINIC, LLC
Street 706 MAIN STREET, STE 2A
City KLAMATH FALLS
State OR
ZIP 97601
Phone 541 591-0877
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2024
Certificate Expiration Date 6/27/2026
Facility Type Physician Office
Lab Director TRACY W. GRAHAM

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