13D2151193 CLIA NUMBER - TERRY REILLY HEALTH SERVICE - NAMPA 16

Laboratory Demographics

CLIA Number: 13D2151193

Facility Name: TERRY REILLY HEALTH SERVICE - NAMPA 16

Facility Address:
223 16TH AVENUE NORTH
NAMPA, ID
ZIP 83687
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Facility Phone Number: 208 466-7869

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1265979629

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D2151193
LAB Type	Federally Qualified Health Center
Facility Name	TERRY REILLY HEALTH SERVICE - NAMPA 16
Street	223 16TH AVENUE NORTH
City	NAMPA
State	ID
ZIP	83687
Phone	208 466-7869
CertificateType	3
CertificateEffectiveDate	7/13/2022
CertificateExpirationDate	7/12/2024
FacilityType	PPMP

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