13D2124589 CLIA NUMBER - TOTAL LIFE CLINIC PLLC

Laboratory Demographics

  • CLIA Code: 13D2124589
  • Facility Name: TOTAL LIFE CLINIC PLLC
  • Facility Address: 2311 PARKE AVE STE 6
    BURLEY, ID
    ZIP 83318
  • Facility Phone: 208 878-6413
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: LACIE S. ASHER FNC-P
  • NPI Number: 1467816199
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D2124589
LAB Type Practitioner Other
Facility Name TOTAL LIFE CLINIC PLLC
Street 2311 PARKE AVE STE 6
City BURLEY
State ID
ZIP 83318
Phone 208 878-6413
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 1/20/2025
Certificate Expiration Date 1/19/2027
Facility Type Practitioner Other
Lab Director LACIE S. ASHER FNC-P

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