38D2291363 CLIA NUMBER - ESTACADA DIRECT PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 38D2291363
  • Facility Name: ESTACADA DIRECT PRIMARY CARE
  • Facility Address: 107 NW 5TH AVE
    ESTACADA, OR
    ZIP 97023
  • Facility Phone: 503 852-5668
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD ORTH
  • NPI Number: 1801663414
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D2291363
LAB Type Physician Office
Facility Name ESTACADA DIRECT PRIMARY CARE
Street 107 NW 5TH AVE
City ESTACADA
State OR
ZIP 97023
Phone 503 852-5668
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2025
Certificate Expiration Date 10/9/2027
Facility Type Physician Office
Lab Director RICHARD ORTH

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