38D0627086 CLIA NUMBER - COTTAGE GROVE POST ACUTE

Laboratory Demographics

  • CLIA Code: 38D0627086
  • Facility Name: COTTAGE GROVE POST ACUTE
  • Facility Address: 515 GRANT AVENUE
    COTTAGE GROVE, OR
    ZIP 97424
  • Facility Phone: 541 942-5528
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: VICTOR A. WALLENKAMPF
  • NPI Number: 1407842800
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 38D0627086
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name COTTAGE GROVE POST ACUTE
Street 515 GRANT AVENUE
City COTTAGE GROVE
State OR
ZIP 97424
Phone 541 942-5528
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2024
Certificate Expiration Date 12/31/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director VICTOR A. WALLENKAMPF

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