13D2268973 CLIA NUMBER - BRC MENTAL HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 13D2268973
  • Facility Name: BRC MENTAL HEALTH SERVICES
  • Facility Address: 963 S ORCHARD ST STE 103
    BOISE, ID
    ZIP 83705
  • Facility Phone: 208 794-1134
  • Facility Type: Other - MENTAL HEALTH
  • Facility Type: Waiver
  • Lab Director: LAURA HARTWIG
  • NPI Number: 1982126264
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 13D2268973
LAB Type Other - MENTAL HEALTH
Facility Name BRC MENTAL HEALTH SERVICES
Street 963 S ORCHARD ST STE 103
City BOISE
State ID
ZIP 83705
Phone 208 794-1134
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Other - MENTAL HEALTH
Lab Director LAURA HARTWIG

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