13D0520679 CLIA NUMBER - NORTH CANYON MEDICAL CENTER

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Laboratory Demographics

CLIA Number: 13D0520679

Facility Name: NORTH CANYON MEDICAL CENTER

Facility Address:
267 NORTH CANYON DR
GOODING, ID
ZIP 83330
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Facility Phone Number: 208 934-4463

Facility Type: Hospital

Certificate Type: Certificate of Compliance

NPI Number: 1558679951

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	13D0520679
LAB Type	Hospital
Facility Name	NORTH CANYON MEDICAL CENTER
Street	267 NORTH CANYON DR
City	GOODING
State	ID
ZIP	83330
Phone	208 934-4463
CertificateType	2
CertificateEffectiveDate	1/25/2023
CertificateExpirationDate	1/24/2025
FacilityType	Compliance

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