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38D0932318 CLIA NUMBER - LEGACY MEDICAL GROUP MOLALLA FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 38D0932318

Facility Name: LEGACY MEDICAL GROUP MOLALLA FAMILY MEDICINE

Facility Address:
861 W MAIN ST
MOLALLA, OR
ZIP 97038
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Facility Phone Number: 503 874-5653

Facility Type: Rural Health Clinic

Certificate Type: Microscopy
NPI Number: 1013191535

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 38D0932318
LAB Type Rural Health Clinic
Facility Name LEGACY MEDICAL GROUP MOLALLA FAMILY MEDICINE
Street 861 W MAIN ST
City MOLALLA
State OR
ZIP 97038
Phone 503 874-5653
CertificateType 3
CertificateEffectiveDate 9/26/2022
CertificateExpirationDate 9/25/2024
FacilityType PPMP

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