38D2039482 CLIA NUMBER - VALLEY PLASTIC SURGERY, LLC

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Laboratory Demographics

CLIA Number: 38D2039482

Facility Name: VALLEY PLASTIC SURGERY, LLC

Facility Address:
280 S PACIFIC HWY
TALENT, OR
ZIP 97540
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Facility Phone Number: 541 512-4771

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124396544

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D2039482
LAB Type	Physician Office
Facility Name	VALLEY PLASTIC SURGERY, LLC
Street	280 S PACIFIC HWY
City	TALENT
State	OR
ZIP	97540
Phone	541 512-4771
CertificateType	4
CertificateEffectiveDate	4/10/2024
CertificateExpirationDate	4/9/2026
FacilityType	Waiver

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