38D0970508 CLIA NUMBER - VALLEY IMMEDIATE CARE LLC

Laboratory Demographics

CLIA Number: 38D0970508

Facility Name: VALLEY IMMEDIATE CARE LLC

Facility Address:
1600 DELTA WATERS ROAD SUITE #107
MEDFORD, OR
ZIP 97504
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Facility Phone Number: 541 858-2515

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1982709226

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D0970508
LAB Type	Physician Office
Facility Name	VALLEY IMMEDIATE CARE LLC
Street	1600 DELTA WATERS ROAD SUITE #107
City	MEDFORD
State	OR
ZIP	97504
Phone	541 858-2515
CertificateType	2
CertificateEffectiveDate	6/27/2022
CertificateExpirationDate	6/26/2024
FacilityType	Compliance

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