13D2050003 CLIA NUMBER - ERLAND INTERNAL MEDICINE PC

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Laboratory Demographics

CLIA Number: 13D2050003

Facility Name: ERLAND INTERNAL MEDICINE PC

Facility Address:
3667 N LOCUST GROVE RD
MERIDIAN, ID
ZIP 83646
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Facility Phone Number: 208 939-9090

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1104177757

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D2050003
LAB Type	Physician Office
Facility Name	ERLAND INTERNAL MEDICINE PC
Street	3667 N LOCUST GROVE RD
City	MERIDIAN
State	ID
ZIP	83646
Phone	208 939-9090
CertificateType	3
CertificateEffectiveDate	11/19/2022
CertificateExpirationDate	11/18/2024
FacilityType	PPMP

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