38D2186922 CLIA NUMBER - SAMARITAN TREATMENT AND RECOVERY SERVICES

Laboratory Demographics

CLIA Number: 38D2186922

Facility Name: SAMARITAN TREATMENT AND RECOVERY SERVICES

Facility Address:
111 N MAIN STREET, STE A&B
LEBANON, OR
ZIP 97355
Get Directions

Facility Phone Number: 541 451-7439

Facility Type: Other - OUTPATIENT & RESIDENTIAL

Certificate Type: Waiver

NPI Number: 1205341617

Taxonomy: 207RA0401X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.

CLIA Record

Field Name	Field Value
CLIA Number	38D2186922
LAB Type	Other - OUTPATIENT & RESIDENTIAL
Facility Name	SAMARITAN TREATMENT AND RECOVERY SERVICES
Street	111 N MAIN STREET, STE A&B
City	LEBANON
State	OR
ZIP	97355
Phone	541 451-7439
CertificateType	4
CertificateEffectiveDate	6/23/2022
CertificateExpirationDate	6/22/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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