13D0056438 CLIA NUMBER - LOST RIVERS MEDICAL CENTER

Laboratory Demographics

CLIA Number: 13D0056438

Facility Name: LOST RIVERS MEDICAL CENTER

Facility Address:
551 HIGHLAND DR
ARCO, ID
ZIP 83213
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Facility Phone Number: 208 252-7654

Facility Type: Hospital

Certificate Type: Certificate of Compliance

NPI Number: 1114925047

Taxonomy: 282NC0060X - General Acute Care Hospital

CLIA Record

Field Name	Field Value
CLIA Number	13D0056438
LAB Type	Hospital
Facility Name	LOST RIVERS MEDICAL CENTER
Street	551 HIGHLAND DR
City	ARCO
State	ID
ZIP	83213
Phone	208 252-7654
CertificateType	2
CertificateEffectiveDate	4/7/2023
CertificateExpirationDate	4/6/2025
FacilityType	Compliance

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