13D0521737 CLIA NUMBER - SAINT ALPHONSUS MEDICAL GROUP - EMERALD

Laboratory Demographics

  • CLIA Code: 13D0521737
  • Facility Name: SAINT ALPHONSUS MEDICAL GROUP - EMERALD
  • Facility Address: 6051 W EMERALD ST
    BOISE, ID
    ZIP 83704
  • Facility Phone: 208 392-8434
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHAE JOHNSON
  • NPI Number: 1093040479
  • Taxonomy: 2086S0127X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 13D0521737
LAB Type Physician Office
Facility Name SAINT ALPHONSUS MEDICAL GROUP - EMERALD
Street 6051 W EMERALD ST
City BOISE
State ID
ZIP 83704
Phone 208 392-8434
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Physician Office
Lab Director SHAE JOHNSON

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