38D0724553 CLIA NUMBER - ASANTE PHYSICIAN PARTNERS FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 38D0724553

Facility Name: ASANTE PHYSICIAN PARTNERS FAMILY MEDICINE

Facility Address:
1250 MIRA MAR AVE
MEDFORD, OR
ZIP 97504
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Facility Phone Number: 541 857-7133

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1922381326

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	38D0724553
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	ASANTE PHYSICIAN PARTNERS FAMILY MEDICINE
Street	1250 MIRA MAR AVE
City	MEDFORD
State	OR
ZIP	97504
Phone	541 857-7133
CertificateType	4
CertificateEffectiveDate	1/1/2024
CertificateExpirationDate	12/31/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024