38D2235642 CLIA NUMBER - ONTRACK ROGUE VALLEY

Laboratory Demographics

CLIA Number: 38D2235642

Facility Name: ONTRACK ROGUE VALLEY

Facility Address:
300 W MAIN ST
MEDFORD, OR
ZIP 97501
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Facility Phone Number: 541 772-1777

Facility Type: Other - A&D INPATIENT AND OUTPATI

Certificate Type: Waiver

NPI Number: 1881685097

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	38D2235642
LAB Type	Other - A&D INPATIENT AND OUTPATI
Facility Name	ONTRACK ROGUE VALLEY
Street	300 W MAIN ST
City	MEDFORD
State	OR
ZIP	97501
Phone	541 772-1777
CertificateType	4
CertificateEffectiveDate	9/10/2023
CertificateExpirationDate	9/9/2025
FacilityType	Waiver

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