13D0056614 CLIA NUMBER - TERRY REILLY HEALTH SERVICES-NAMPA 1ST

Laboratory Demographics

CLIA Number: 13D0056614

Facility Name: TERRY REILLY HEALTH SERVICES-NAMPA 1ST

Facility Address:
207 1ST ST S
NAMPA, ID
ZIP 83651
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Facility Phone Number: 208 318-1267

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1265979629

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D0056614
LAB Type	Federally Qualified Health Center
Facility Name	TERRY REILLY HEALTH SERVICES-NAMPA 1ST
Street	207 1ST ST S
City	NAMPA
State	ID
ZIP	83651
Phone	208 318-1267
CertificateType	3
CertificateEffectiveDate	6/1/2022
CertificateExpirationDate	5/31/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024