13D0520845 CLIA NUMBER - COMMUNITY CARE IDAHO FALLS WEST

Laboratory Demographics

  • CLIA Code: 13D0520845
  • Facility Name: COMMUNITY CARE IDAHO FALLS WEST
  • Facility Address: 765 S UTAH AVE
    IDAHO FALLS, ID
    ZIP 83402
  • Facility Phone: 208 525-2600
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: ETHAN MCCARTY
  • NPI Number: 1790708832
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D0520845
LAB Type Physician Office
Facility Name COMMUNITY CARE IDAHO FALLS WEST
Street 765 S UTAH AVE
City IDAHO FALLS
State ID
ZIP 83402
Phone 208 525-2600
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 2/7/2024
Certificate Expiration Date 2/6/2026
Facility Type Physician Office
Lab Director ETHAN MCCARTY

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