13D1088194 CLIA NUMBER - WHITEWATER HEALTHCARE LLC DBA SYMBII HOME HEALTH

Laboratory Demographics

CLIA Number: 13D1088194

Facility Name: WHITEWATER HEALTHCARE LLC DBA SYMBII HOME HEALTH

Facility Address:
240 W BURNSIDE AVE #B
CHUBBUCK, ID
ZIP 83202
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Facility Phone Number: 208 637-2273

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1619591161

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	13D1088194
LAB Type	Home Health Agency
Facility Name	WHITEWATER HEALTHCARE LLC DBA SYMBII HOME HEALTH
Street	240 W BURNSIDE AVE #B
City	CHUBBUCK
State	ID
ZIP	83202
Phone	208 637-2273
CertificateType	4
CertificateEffectiveDate	8/19/2022
CertificateExpirationDate	8/18/2024
FacilityType	Waiver

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