13D2195041 CLIA NUMBER - EDGEWOOD CASTLE HILLS LLC

Laboratory Demographics

  • CLIA Code: 13D2195041
  • Facility Name: EDGEWOOD CASTLE HILLS LLC
  • Facility Address: 5955 CASTLE DR
    BOISE, ID
    ZIP 83703
  • Facility Phone: 208 331-1300
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: LISA PERREDOUD
  • NPI Number: 1023671435
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 13D2195041
LAB Type Assisted Living Facility
Facility Name EDGEWOOD CASTLE HILLS LLC
Street 5955 CASTLE DR
City BOISE
State ID
ZIP 83703
Phone 208 331-1300
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 LISA PERREDOUD

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