13D2211081 CLIA NUMBER - HEALTHY BALANCE DIRECT CARE

Laboratory Demographics

  • CLIA Code: 13D2211081
  • Facility Name: HEALTHY BALANCE DIRECT CARE
  • Facility Address: 524 CLEVELAND BLVD STE 110
    CALDWELL, ID
    ZIP 83605
  • Facility Phone: 208 459-1503
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HEATHER STOLWORTHY
  • NPI Number: 1952895294
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 13D2211081
LAB Type Physician Office
Facility Name HEALTHY BALANCE DIRECT CARE
Street 524 CLEVELAND BLVD STE 110
City CALDWELL
State ID
ZIP 83605
Phone 208 459-1503
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Physician Office
Lab Director HEATHER STOLWORTHY

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