13D2276425 CLIA NUMBER - HERITAGE HEALTH ADDICTION SERVICES ST MARIES

Laboratory Demographics

  • CLIA Code: 13D2276425
  • Facility Name: HERITAGE HEALTH ADDICTION SERVICES ST MARIES
  • Facility Address: 120 S 13 STREET
    ST MARIES, ID
    ZIP 83861
  • Facility Phone: 208 245-4363
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DAVID ATKINS
  • NPI Number: 1568910156
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D2276425
LAB Type Federally Qualified Health Center
Facility Name HERITAGE HEALTH ADDICTION SERVICES ST MARIES
Street 120 S 13 STREET
City ST MARIES
State ID
ZIP 83861
Phone 208 245-4363
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2025
Certificate Expiration Date 2/7/2027
Facility Type Federally Qualified Health Center
Lab Director DAVID ATKINS

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