13D2104558 CLIA NUMBER - HERITAGE HEALTH POST FALLS

Laboratory Demographics

CLIA Number: 13D2104558

Facility Name: HERITAGE HEALTH POST FALLS

Facility Address:
925 E POLSTON
POST FALLS, ID
ZIP 83854
Get Directions

Facility Phone Number: 208 625-5640

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1841696952

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D2104558
LAB Type	Federally Qualified Health Center
Facility Name	HERITAGE HEALTH POST FALLS
Street	925 E POLSTON
City	POST FALLS
State	ID
ZIP	83854
Phone	208 625-5640
CertificateType	4
CertificateEffectiveDate	11/6/2023
CertificateExpirationDate	11/5/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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