13D2123498 CLIA NUMBER - LIFEWAYS INC

Laboratory Demographics

  • CLIA Code: 13D2123498
  • Facility Name: LIFEWAYS INC
  • Facility Address: 2609 S 10TH AVE STE 102
    CALDWELL, ID
    ZIP 83605
  • Facility Phone: 541 889-9167
  • Facility Type: Other - OUTPATIENT MENTAL HEALTH
  • Facility Type: Waiver
  • Lab Director: JUDY CORDENIZ
  • NPI Number: 1417183906
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 13D2123498
LAB Type Other - OUTPATIENT MENTAL HEALTH
Facility Name LIFEWAYS INC
Street 2609 S 10TH AVE STE 102
City CALDWELL
State ID
ZIP 83605
Phone 541 889-9167
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Other - OUTPATIENT MENTAL HEALTH
Lab Director JUDY CORDENIZ

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This page was last updated on: 9/29/2025