38D0968045 CLIA NUMBER - KLAMATH TRIBAL HEALTH & FAMILY SERVICES

Laboratory Demographics

CLIA Number: 38D0968045

Facility Name: KLAMATH TRIBAL HEALTH & FAMILY SERVICES

Facility Address:
330 CHILOQUIN BLVD
CHILOQUIN, OR
ZIP 97624
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Facility Phone Number: 541 882-1487

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1629078274

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D0968045
LAB Type	Other
Facility Name	KLAMATH TRIBAL HEALTH & FAMILY SERVICES
Street	330 CHILOQUIN BLVD
City	CHILOQUIN
State	OR
ZIP	97624
Phone	541 882-1487
CertificateType	4
CertificateEffectiveDate	12/1/2023
CertificateExpirationDate	11/30/2025
FacilityType	Waiver

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