13D2102577 CLIA NUMBER - TERRY REILLY HEALTH SERVICES-CALDWELL

Laboratory Demographics

CLIA Number: 13D2102577

Facility Name: TERRY REILLY HEALTH SERVICES-CALDWELL

Facility Address:
808 CLEVELAND BLVD
CALDWELL, ID
ZIP 83605
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Facility Phone Number: 208 459-1025

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1831574276

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D2102577
LAB Type	Federally Qualified Health Center
Facility Name	TERRY REILLY HEALTH SERVICES-CALDWELL
Street	808 CLEVELAND BLVD
City	CALDWELL
State	ID
ZIP	83605
Phone	208 459-1025
CertificateType	3
CertificateEffectiveDate	9/25/2023
CertificateExpirationDate	9/24/2025
FacilityType	PPMP

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