38D2253606 CLIA NUMBER - PACIFIC CREST INTEGRATIVE MEDICINE PC

Laboratory Demographics

CLIA Number: 38D2253606

Facility Name: PACIFIC CREST INTEGRATIVE MEDICINE PC

Facility Address:
595 N MAIN ST, STE 2
ASHLAND, OR
ZIP 97520
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Facility Phone Number: 541 488-1116

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1053084384

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	38D2253606
LAB Type	Physician Office
Facility Name	PACIFIC CREST INTEGRATIVE MEDICINE PC
Street	595 N MAIN ST, STE 2
City	ASHLAND
State	OR
ZIP	97520
Phone	541 488-1116
CertificateType	4
CertificateEffectiveDate	2/23/2024
CertificateExpirationDate	2/22/2026
FacilityType	Waiver

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