13D2085426 CLIA NUMBER - SANDPOINT SURGERY CENTER

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Laboratory Demographics

CLIA Number: 13D2085426

Facility Name: SANDPOINT SURGERY CENTER

Facility Address:
1327 SUPERIOR ST #111
SANDPOINT, ID
ZIP 83864
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Facility Phone Number: 208 501-8895

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1619370434

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D2085426
LAB Type	Ambulatory Surgery Center
Facility Name	SANDPOINT SURGERY CENTER
Street	1327 SUPERIOR ST #111
City	SANDPOINT
State	ID
ZIP	83864
Phone	208 501-8895
CertificateType	4
CertificateEffectiveDate	10/14/2022
CertificateExpirationDate	10/13/2024
FacilityType	Waiver

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