13D2035328 CLIA NUMBER - CANYON HOME CARE & HOSPICE

Laboratory Demographics

  • CLIA Code: 13D2035328
  • Facility Name: CANYON HOME CARE & HOSPICE
  • Facility Address: 929 NW 16TH ST
    FRUITLAND, ID
    ZIP 83619
  • Facility Phone: 208 642-1838
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: EMILY VICKERY
  • NPI Number: 1831135474
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 13D2035328
LAB Type Home Health Agency
Facility Name CANYON HOME CARE & HOSPICE
Street 929 NW 16TH ST
City FRUITLAND
State ID
ZIP 83619
Phone 208 642-1838
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type Home Health Agency
Lab Director EMILY VICKERY

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