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General NPI Number Information
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NPI Number | 1649392366
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Entity Type | Organization
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Legal Business Name | CENTRAL OREGON REGIONAL PATHOLOGY SERVICES, LLC
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1348 NE CUSHING DR SUITE 210
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City | BEND
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State | OR
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Zip | 97701-3876
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Country | US
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Telephone | 541-382-7696
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Fax | 541-389-5723
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Provider Business Mailing Address
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Address Line | PO BOX 7096
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City | SPRINGFIELD
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State | OR
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Zip | 97475-0005
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Country | US
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Telephone | 541-382-7696
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Fax | 541-389-5723
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. IRENE CZYSZCZON
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Credential | DO
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Telephone | 541-382-7696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246QC2700X
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Taxonomy Name | Cytotechnology Specialist/Technologist
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License Number | 38D0656805
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 246R00000X
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Taxonomy Name | Pathology Technician
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License Number | 38D0656805
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 246QH0600X
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Taxonomy Name | Histology Specialist/Technologist
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License Number | 38D0656805
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 38D0656805
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License Number State | OR
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