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CH10079J LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC (Active)
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Main Details
Name
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC
Subdivision Name
La Clinica School-Based Health Center at Washington Elementary School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005004
340B ID
CH10079J
Grant Number
H80CS00759
Additional Details
Current Program Status
Active
Registration Date
10/4/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/18/2012
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
610 S PEACH ST
MEDFORD, OR 97501-3310
Billing Address
La Clinica Del Valle Family Health Care Center Inc
931 Chevy Way
Medford, OR 97504
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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