Organization
VENTANA WELLNESS, PC
Active
Other names
Rogue Clinical Laboratories
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY VAN ES (BILLING SUPERVISOR)
(541) 842-7134
Entity
Organization
Contact information
Practice address
3156 STATE ST, MEDFORD, OR 97504
(541) 773-9772
(541) 773-1113
Mailing address
3156 STATE ST, MEDFORD, OR 97504-8450
(541) 773-9772
(541) 773-1113
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
11/07/2006
Last updated
05/03/2011
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