13D2195026 CLIA NUMBER - EDGEWOOD SPRING CREEK USTICK LLC

Laboratory Demographics

  • CLIA Code: 13D2195026
  • Facility Name: EDGEWOOD SPRING CREEK USTICK LLC
  • Facility Address: 3165 N MERIDIAN RD
    MERIDIAN, ID
    ZIP 83646
  • Facility Phone: 208 287-2064
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ASHLEY CHECKETTS
  • NPI Number: 1225313737
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 13D2195026
LAB Type Assisted Living Facility
Facility Name EDGEWOOD SPRING CREEK USTICK LLC
Street 3165 N MERIDIAN RD
City MERIDIAN
State ID
ZIP 83646
Phone 208 287-2064
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2024
Certificate Expiration Date 10/5/2026
Facility Type Assisted Living Facility
Lab Director ASHLEY CHECKETTS

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