Organization
CENTRAL OREGON CLINICAL GENETICS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSVALDO ANTONIO SCHIRRIPA M.D. (DIRECTOR/OWNER)
(541) 749-8196
Entity
Organization
Contact information
Practice address
143 SW SHEVLIN HIXON DR, SUITE #203, BEND, OR 97702-3189
(541) 749-8196
(541) 678-5466
Mailing address
143 SW SHEVLIN HIXON DR, SUITE #203, BEND, OR 97702-3189
(541) 749-8196
(541) 678-5466
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
MD153157
OR
261QM2500X
Medical Specialty Clinic/Center
Primary
MD153157
OR
291U00000X
Clinical Medical Laboratory
A46201
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500637246
—
OR
05
—
500637292
—
OR
Enumeration date
05/03/2011
Last updated
03/14/2012
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