13D2186543 CLIA NUMBER - COEUR VITALITY PLLC

Laboratory Demographics

  • CLIA Code: 13D2186543
  • Facility Name: COEUR VITALITY PLLC
  • Facility Address: 110 E WALLACE AVE
    COEUR D'ALENE, ID
    ZIP 83814
  • Facility Phone: 208 853-0707
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRITTANY C. BURNS
  • NPI Number: 1316574700
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D2186543
LAB Type Physician Office
Facility Name COEUR VITALITY PLLC
Street 110 E WALLACE AVE
City COEUR D'ALENE
State ID
ZIP 83814
Phone 208 853-0707
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 6/18/2024
Certificate Expiration Date 6/17/2026
Facility Type Physician Office
Lab Director BRITTANY C. BURNS

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