13D0679491 CLIA NUMBER - HERITAGE HEALTH KELLOGG

Laboratory Demographics

  • CLIA Code: 13D0679491
  • Facility Name: HERITAGE HEALTH KELLOGG
  • Facility Address: 740 MCKINLEY AVE W
    KELLOGG, ID
    ZIP 83837
  • Facility Phone: 208 625-5250
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: ANTHONY REHIL-CREST
  • NPI Number: 1487076048
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D0679491
LAB Type Federally Qualified Health Center
Facility Name HERITAGE HEALTH KELLOGG
Street 740 MCKINLEY AVE W
City KELLOGG
State ID
ZIP 83837
Phone 208 625-5250
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2024
Certificate Expiration Date 10/24/2026
Facility Type Federally Qualified Health Center
Lab Director ANTHONY REHIL-CREST

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This page was last updated on: 9/29/2025