13D2217375 CLIA NUMBER - DEMEAN HEALTHCARE SOLUTIONS LLC

Laboratory Demographics

CLIA Number: 13D2217375

Facility Name: DEMEAN HEALTHCARE SOLUTIONS LLC

Facility Address:
1331 G STREET
LEWISTON, ID
ZIP 83501
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Facility Phone Number: 208 743-9616

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1932722451

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	13D2217375
LAB Type	Practitioner Other
Facility Name	DEMEAN HEALTHCARE SOLUTIONS LLC
Street	1331 G STREET
City	LEWISTON
State	ID
ZIP	83501
Phone	208 743-9616
CertificateType	4
CertificateEffectiveDate	3/19/2023
CertificateExpirationDate	3/18/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024