38D1087295 CLIA NUMBER - WILLAMETTE VALLEY HOSPICE

Laboratory Demographics

CLIA Number: 38D1087295

Facility Name: WILLAMETTE VALLEY HOSPICE

Facility Address:
1015 3RD ST NW
SALEM, OR
ZIP 97304
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Facility Phone Number: 503 588-3600

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1093715070

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	38D1087295
LAB Type	Hospice
Facility Name	WILLAMETTE VALLEY HOSPICE
Street	1015 3RD ST NW
City	SALEM
State	OR
ZIP	97304
Phone	503 588-3600
CertificateType	4
CertificateEffectiveDate	7/31/2022
CertificateExpirationDate	7/30/2024
FacilityType	Waiver

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