BIRCH GROVE HEALTH CENTER- LA CLINICA
NPI 1417372731
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 February 24, 2014CLIA 38D2154062 · Microscopy

910 S CENTRAL AVE, MEDFORD, OR 97501(541) 618-1380(541) 618-1385 Get Directions Write a Review

NPPES record last updated: July 15, 2019. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jul 15, 2019, Jan 18, 2019, Jun 13, 2018 (3 updates tracked since 2018).

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About Birch Grove Health Center- La Clinica NPPES

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

BIRCH GROVE HEALTH CENTER- LA CLINICA (NPI 1417372731) is a healthcare organization registered as a federally qualified health center (fqhc) in Medford, Oregon and active in the NPI registry since February 2014. The organization holds a CLIA Microscopy certificate valid through September 4, 2028 and lists Tara Lynette Jeannot, Chief Operations Officer, as its authorized official.

NPPES Registry Identity

NPI1417372731

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameLA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC

Location Address910 S CENTRAL AVEMedford, OR 97501-7822

Mailing Address931 Chevy WayMedford, OR 97504-4127 · (541) 535-6239 · Fax (541) 842-2212

Phone(541) 618-1380

Fax(541) 618-1385

Organization SubpartYesParent: La Clinica Del Valle Family Health Care Center Inc.

Authorized OfficialTara Lynette JeannotChief Operations Officer · (541) 535-6239

Enumeration DateFebruary 24, 2014

Last NPPES UpdateJuly 15, 20193 updates tracked since enumeration

✔ NPI 1417372731 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

910 S CENTRAL AVE, Medford, OR 97501

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Other Names 1

Doing Business AsBirch Grove Health Center- La Clinica

Other Identifiers 1

Medicaid022868OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

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) 38D2154062

Birch Grove Health Center-La Clinica · Medford, OR

Active · expires Sep 4, 2028

CLIA Number38D2154062

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateSeptember 5, 2026

Certificate Expiration DateSeptember 4, 2028

Laboratory DirectorNathaniel Fondell

Laboratory Phone(541) 618-1380

Laboratory LocationBirch Grove Health Center-La Clinica910 S Central Ave, Medford, OR 97501

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 17

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

LAUREL M BROWN PA

Physician Assistant