13D2149215 CLIA NUMBER - FALLS AVENUE IMMEDIATE CARE

Laboratory Demographics

CLIA Number: 13D2149215

Facility Name: FALLS AVENUE IMMEDIATE CARE

Facility Address:
260 FALLS AVE
TWIN FALLS, ID
ZIP 83301
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Facility Phone Number: 208 733-6700

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1912481292

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D2149215
LAB Type	Physician Office
Facility Name	FALLS AVENUE IMMEDIATE CARE
Street	260 FALLS AVE
City	TWIN FALLS
State	ID
ZIP	83301
Phone	208 733-6700
CertificateType	3
CertificateEffectiveDate	5/29/2022
CertificateExpirationDate	5/28/2024
FacilityType	PPMP

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