13D2180351 CLIA NUMBER - AGELESS MEN'S HEALTH

Laboratory Demographics

CLIA Number: 13D2180351

Facility Name: AGELESS MEN'S HEALTH

Facility Address:
3875 E OVERLAND RD 1E
MERIDIAN, ID
ZIP 83642
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Facility Phone Number: 208 906-9128

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1457983462

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	13D2180351
LAB Type	Physician Office
Facility Name	AGELESS MEN'S HEALTH
Street	3875 E OVERLAND RD 1E
City	MERIDIAN
State	ID
ZIP	83642
Phone	208 906-9128
CertificateType	4
CertificateEffectiveDate	3/12/2024
CertificateExpirationDate	3/11/2026
FacilityType	Waiver

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