13D2123747 CLIA NUMBER - THE HEALING SANCTUARY

Laboratory Demographics

  • CLIA Code: 13D2123747
  • Facility Name: THE HEALING SANCTUARY
  • Facility Address: 187 EAST 13TH STREET
    IDAHO FALLS, ID
    ZIP 83404
  • Facility Phone: 208 497-0500
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JEFFREY B. BAKER
  • NPI Number: 1346799483
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D2123747
LAB Type Physician Office
Facility Name THE HEALING SANCTUARY
Street 187 EAST 13TH STREET
City IDAHO FALLS
State ID
ZIP 83404
Phone 208 497-0500
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/30/2024
Certificate Expiration Date 12/29/2026
Facility Type Physician Office
Lab Director JEFFREY B. BAKER

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