13D0975825 CLIA NUMBER - VISION CARE CENTER OF IDAHO

Laboratory Demographics

CLIA Number: 13D0975825

Facility Name: VISION CARE CENTER OF IDAHO

Facility Address:
3071 E FRANKLIN RD STE 101
MERIDIAN, ID
ZIP 83642
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Facility Phone Number: 208 655-3937

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1083674196

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D0975825
LAB Type	Ambulatory Surgery Center
Facility Name	VISION CARE CENTER OF IDAHO
Street	3071 E FRANKLIN RD STE 101
City	MERIDIAN
State	ID
ZIP	83642
Phone	208 655-3937
CertificateType	4
CertificateEffectiveDate	7/19/2022
CertificateExpirationDate	7/18/2024
FacilityType	Waiver

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