38D2226159 CLIA NUMBER - SARAH SORIC THERAPY LLC DBA DYNAMIC SELF RECOVERY

Laboratory Demographics

CLIA Number: 38D2226159

Facility Name: SARAH SORIC THERAPY LLC DBA DYNAMIC SELF RECOVERY

Facility Address:
433 3RD AVE SE
ALBANY, OR
ZIP 97321
Get Directions

Facility Phone Number: 541 791-7193

Facility Type: Other - DRUG OUTPATIENT TREATMENT

Certificate Type: Waiver

NPI Number: 1083205298

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D2226159
LAB Type	Other - DRUG OUTPATIENT TREATMENT
Facility Name	SARAH SORIC THERAPY LLC DBA DYNAMIC SELF RECOVERY
Street	433 3RD AVE SE
City	ALBANY
State	OR
ZIP	97321
Phone	541 791-7193
CertificateType	4
CertificateEffectiveDate	5/26/2023
CertificateExpirationDate	5/25/2025
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