13D2011402 CLIA NUMBER - LEGENDS PARK ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 13D2011402
  • Facility Name: LEGENDS PARK ASSISTED LIVING
  • Facility Address: 1820 N LEGENDS PARKWAY
    COEUR D ALENE, ID
    ZIP 83815
  • Facility Phone: 208 666-9900
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: SHAYLA M. ARCHER
  • NPI Number: 1154458354
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 13D2011402
LAB Type Assisted Living Facility
Facility Name LEGENDS PARK ASSISTED LIVING
Street 1820 N LEGENDS PARKWAY
City COEUR D ALENE
State ID
ZIP 83815
Phone 208 666-9900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2024
Certificate Expiration Date 8/16/2026
Facility Type Assisted Living Facility
Lab Director SHAYLA M. ARCHER

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