38D0984684 CLIA NUMBER - SURGERY CENTER OF SOUTHERN OREGON

Laboratory Demographics

CLIA Number: 38D0984684

Facility Name: SURGERY CENTER OF SOUTHERN OREGON

Facility Address:
2798 E BARNETT ROAD
MEDFORD, OR
ZIP 97504
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Facility Phone Number: 541 858-8100

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1841286267

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D0984684
LAB Type	Physician Office
Facility Name	SURGERY CENTER OF SOUTHERN OREGON
Street	2798 E BARNETT ROAD
City	MEDFORD
State	OR
ZIP	97504
Phone	541 858-8100
CertificateType	4
CertificateEffectiveDate	3/27/2023
CertificateExpirationDate	3/26/2025
FacilityType	Waiver

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