38D2003120 CLIA NUMBER - ROGUE VALLEY SURGERY CENTER LLC

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Laboratory Demographics

CLIA Number: 38D2003120

Facility Name: ROGUE VALLEY SURGERY CENTER LLC

Facility Address:
1411 E MCANDREWS ROAD
MEDFORD, OR
ZIP 97504
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Facility Phone Number: 541 773-1435

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1336479021

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D2003120
LAB Type	Ambulatory Surgery Center
Facility Name	ROGUE VALLEY SURGERY CENTER LLC
Street	1411 E MCANDREWS ROAD
City	MEDFORD
State	OR
ZIP	97504
Phone	541 773-1435
CertificateType	4
CertificateEffectiveDate	2/2/2024
CertificateExpirationDate	2/1/2026
FacilityType	Waiver

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