13D2014600 CLIA NUMBER - CENTER FOR PLASTIC SURGERY

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Laboratory Demographics

CLIA Number: 13D2014600

Facility Name: CENTER FOR PLASTIC SURGERY

Facility Address:
1880 FILLMORE ST
TWIN FALLS, ID
ZIP 83301
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Facility Phone Number: 208 735-8386

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1154577203

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D2014600
LAB Type	Ambulatory Surgery Center
Facility Name	CENTER FOR PLASTIC SURGERY
Street	1880 FILLMORE ST
City	TWIN FALLS
State	ID
ZIP	83301
Phone	208 735-8386
CertificateType	4
CertificateEffectiveDate	10/13/2022
CertificateExpirationDate	10/12/2024
FacilityType	Waiver

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