13D2194051 CLIA NUMBER - GRACE AT FAIRVIEW LAKES LLC

Laboratory Demographics

  • CLIA Code: 13D2194051
  • Facility Name: GRACE AT FAIRVIEW LAKES LLC
  • Facility Address: 1960 N LAKES PLACE
    MERIDIAN, ID
    ZIP 83642
  • Facility Phone: 208 884-8080
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MONICA HEATH
  • NPI Number: 1790309045
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 13D2194051
LAB Type Assisted Living Facility
Facility Name GRACE AT FAIRVIEW LAKES LLC
Street 1960 N LAKES PLACE
City MERIDIAN
State ID
ZIP 83642
Phone 208 884-8080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Assisted Living Facility
Lab Director MONICA HEATH

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