13D2172574 CLIA NUMBER - BELLA FAMILY HEALTHCARE & AESTHETICS LLC

Laboratory Demographics

CLIA Number: 13D2172574

Facility Name: BELLA FAMILY HEALTHCARE & AESTHETICS LLC

Facility Address:
1545 LEIGHFIELD STE 100
MERIDIAN, ID
ZIP 83646
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Facility Phone Number: 208 957-6871

Facility Type: Independent

Certificate Type: Waiver

NPI Number: 1275186835

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D2172574
LAB Type	Independent
Facility Name	BELLA FAMILY HEALTHCARE & AESTHETICS LLC
Street	1545 LEIGHFIELD STE 100
City	MERIDIAN
State	ID
ZIP	83646
Phone	208 957-6871
CertificateType	4
CertificateEffectiveDate	9/25/2023
CertificateExpirationDate	9/24/2025
FacilityType	Waiver

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