38D0627736 CLIA NUMBER - ROGUE VALLEY PHYSICIANS/FAMILY PRACTICE GROUP

Laboratory Demographics

  • CLIA Code: 38D0627736
  • Facility Name: ROGUE VALLEY PHYSICIANS/FAMILY PRACTICE GROUP
  • Facility Address: 229 W STEWART AVE
    MEDFORD, OR
    ZIP 97501
  • Facility Phone: 541 282-8808
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRYAN D. WALLS
  • NPI Number: 1114190121
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D0627736
LAB Type Physician Office
Facility Name ROGUE VALLEY PHYSICIANS/FAMILY PRACTICE GROUP
Street 229 W STEWART AVE
City MEDFORD
State OR
ZIP 97501
Phone 541 282-8808
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/2/2025
Certificate Expiration Date 1/1/2027
Facility Type Physician Office
Lab Director BRYAN D. WALLS

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