13D2123747 CLIA NUMBER - THE HEALING SANCTUARY

Laboratory Demographics

CLIA Number: 13D2123747

Facility Name: THE HEALING SANCTUARY

Facility Address:
187 EAST 13TH STREET
IDAHO FALLS, ID
ZIP 83404
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Facility Phone Number: 208 497-0500

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1346799483

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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
CertificateType	3
CertificateEffectiveDate	12/30/2022
CertificateExpirationDate	12/29/2024
FacilityType	PPMP

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