38D0689701 CLIA NUMBER - AVAMERE AT THREE FOUNTAINS

Laboratory Demographics

  • CLIA Code: 38D0689701
  • Facility Name: AVAMERE AT THREE FOUNTAINS
  • Facility Address: 835 CRATER LAKE AVE
    MEDFORD, OR
    ZIP 97504
  • Facility Phone: 541 773-7717
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: PRISCILLA ESPINOSA
  • NPI Number: 1114965894
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 38D0689701
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AVAMERE AT THREE FOUNTAINS
Street 835 CRATER LAKE AVE
City MEDFORD
State OR
ZIP 97504
Phone 541 773-7717
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 PRISCILLA ESPINOSA

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