LA CLINICA WELLNESS CENTER
NPI 1669848792
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 August 12, 2015CLIA 38D2154053 · Microscopy

730 BIDDLE RD, MEDFORD, OR 97504(541) 494-3800(541) 494-0895 Get Directions Write a Review

NPPES record last updated: July 15, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 15, 2019, Jun 13, 2018 (2 updates tracked since 2018).

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About La Clinica Wellness Center NPPES

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

LA CLINICA WELLNESS CENTER (NPI 1669848792) is a healthcare organization registered as a federally qualified health center (fqhc) in Medford, Oregon and active in the NPI registry since August 2015. The organization holds a CLIA Microscopy certificate valid through September 4, 2026 and lists Tara Lynette Jeannot, Chief Operations Officer, as its authorized official.

NPPES Registry Identity

NPI1669848792

Entity TypeOrganization

Primary Taxonomy261QF0400X

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

Location Address730 BIDDLE RDMedford, OR 97504

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

Phone(541) 494-3800

Fax(541) 494-0895

Organization SubpartYes

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

Enumeration DateAugust 12, 2015

Last NPPES UpdateJuly 15, 20192 updates tracked since enumeration

✔ NPI 1669848792 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

730 BIDDLE RD, Medford, OR 97504

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Other Names 1

Doing Business AsLa Clinica Wellness Center

Other Identifiers 1

Other261QF0400XOR · Clinic/center/federally Qualified Health Center

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) 38D2154053

La Clinica Wellness Clinic · Medford, OR

Active · expires Sep 4, 2026

CLIA Number38D2154053

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateSeptember 5, 2024

Certificate Expiration DateSeptember 4, 2026

Laboratory DirectorBrian Marlia-Larsen

Laboratory Phone(541) 494-3820

Laboratory LocationLa Clinica Wellness Clinic730 Biddle Rd, Medford, OR 97504

CLIA data matches this NPI record on: Address

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 20

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

NOAH DRAKE LPC

Counselor (Mental Health)