13D0520979 CLIA NUMBER - TETON VALLEY HOSPITAL

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Laboratory Demographics

CLIA Number: 13D0520979

Facility Name: TETON VALLEY HOSPITAL

Facility Address:
120 E HOWARD ST
DRIGGS, ID
ZIP 83422
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Facility Phone Number: 208 354-6327

Facility Type: Hospital

Certificate Type: Certificate of Compliance

NPI Number: 1801143029

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D0520979
LAB Type	Hospital
Facility Name	TETON VALLEY HOSPITAL
Street	120 E HOWARD ST
City	DRIGGS
State	ID
ZIP	83422
Phone	208 354-6327
CertificateType	2
CertificateEffectiveDate	9/20/2023
CertificateExpirationDate	9/19/2025
FacilityType	Compliance

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