13D2255709 CLIA NUMBER - HEALTHY HABITS WELLNESS CLINIC

Laboratory Demographics

CLIA Number: 13D2255709

Facility Name: HEALTHY HABITS WELLNESS CLINIC

Facility Address:
14 S BALTIC PL
MERIDIAN, ID
ZIP 83642
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Facility Phone Number: 208 887-4872

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1336273267

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	13D2255709
LAB Type	Physician Office
Facility Name	HEALTHY HABITS WELLNESS CLINIC
Street	14 S BALTIC PL
City	MERIDIAN
State	ID
ZIP	83642
Phone	208 887-4872
CertificateType	4
CertificateEffectiveDate	3/16/2024
CertificateExpirationDate	3/15/2026
FacilityType	Waiver

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