Clinical Laboratory Information
Similar CLIA Codes
|
|
CLIA Number
|
13D2235428
|
|
Clinical laboratory number
|
|
Lab Name
|
HERITAGE HEALTH STREET MEDICINE
|
|
Laboratory Name
|
|
Lab Type
|
Federally Qualified Health Center
|
|
Laboratory Type
|
|
Certificate Type
|
Waiver
|
|
Clinical laboratory certificate type
|
Contacts |
|
Phone
|
208-292-0303
|
|
Laboratory telephone number
|
|
Fax
|
208-667-6547
|
|
Fax number of the provider.
|
Facility Location |
|
Street Address
|
2205 IRONWOOD PLACE
|
|
Primary location adress line
|
|
City
|
COEUR D'ALENE
|
|
Primary location city name
|
|
State
|
ID
|
|
Primary location state name
|
|
Zip
|
83814
|
|
Primary location postal code
|