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CH10079AJ LA CLINCA DEL VALLE FAMILY HEALTH CENTER INC (Active)
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Main Details
Name
LA CLINCA DEL VALLE FAMILY HEALTH CENTER INC
Subdivision Name
Center for Learning and Innovation--La Clinica
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027512
340B ID
CH10079AJ
Grant Number
H80CS00759
Additional Details
Current Program Status
Active
Registration Date
7/2/2024
Participating Start Date
10/1/2024
Participating Approval Date
8/13/2024
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
La Clinica del Valle
Traci Fossen, Chief Quality Officer
(541) 512-3912
Primary Contact
La Clinica del Valle
Sochil Castillo, Compliance Coordinator
(541) 512-3127
Addresses
Street Address
931 Chevy Way
Medford, OR 97504-4127
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
June 2025
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