LA CLINICA ACUTE CARE CLINIC
NPI 1073100202
Clinic/Center - Federally Qualified Health Center (FQHC) in Medford, OR

Q: What is La Clinica Del Valle Family Health Care Center Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since December 22, 2020CLIA 38D2208571 · Microscopy

638 MARKET ST, MEDFORD, OR 97504(541) 494-3840(541) 494-1789 Get Directions Write a Review

NPPES record last updated: May 31, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About La Clinica Acute Care Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LA CLINICA ACUTE CARE CLINIC (NPI 1073100202) is a healthcare organization registered as a federally qualified health center (fqhc) in Medford, Oregon and active in the NPI registry since December 2020. The organization holds a CLIA Microscopy certificate valid through February 19, 2027 and lists Tara Lynette Jeannot, Coo, as its authorized official.

NPPES Registry Identity

NPI1073100202

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameLA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.

Location Address638 MARKET STMedford, OR 97504-6126

Mailing Address931 Chevy WayMedford, OR 97504-4127 · (541) 690-3555

Phone(541) 494-3840

Fax(541) 494-1789

Organization SubpartYes

Authorized OfficialTara Lynette JeannotCoo · (541) 535-6239

Enumeration DateDecember 22, 2020

Last NPPES UpdateMay 31, 2024

NPPES CertifiedMay 31, 2024

✔ NPI 1073100202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

638 MARKET ST, Medford, OR 97504

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Other Names 1

Doing Business AsLa Clinica Acute Care Clinic

Other Identifiers 1

Medicaid022868OR

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 38D2208571

La Clinica Acute Care Clinic · Medford, OR

Active · expires Feb 19, 2027

CLIA Number38D2208571

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateFebruary 20, 2025

Certificate Expiration DateFebruary 19, 2027

Laboratory DirectorKathryn Warner

Laboratory Phone(541) 494-3840

Laboratory LocationLa Clinica Acute Care Clinic638 Market Street, Medford, OR 97504

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JONI JOHNSON BSN, RN

Registered Nurse