13D2047069 CLIA NUMBER - PLEASANT VIEW SURGERY CENTER

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Laboratory Demographics

CLIA Number: 13D2047069

Facility Name: PLEASANT VIEW SURGERY CENTER

Facility Address:
4171 W EXPO PKWY
POST FALLS, ID
ZIP 83854
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Facility Phone Number: 208 262-3823

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1669720397

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D2047069
LAB Type	Ambulatory Surgery Center
Facility Name	PLEASANT VIEW SURGERY CENTER
Street	4171 W EXPO PKWY
City	POST FALLS
State	ID
ZIP	83854
Phone	208 262-3823
CertificateType	4
CertificateEffectiveDate	9/18/2022
CertificateExpirationDate	9/17/2024
FacilityType	Waiver

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