13D0521990 CLIA NUMBER - PRIMARY HEALTH MEDICAL GROUP - OVERLAND

Laboratory Demographics

  • CLIA Code: 13D0521990
  • Facility Name: PRIMARY HEALTH MEDICAL GROUP - OVERLAND
  • Facility Address: 8971 W OVERLAND RD
    BOISE, ID
    ZIP 83709
  • Facility Phone: 208 378-4288
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CYRUS VANIA
  • NPI Number: 1316183668
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D0521990
LAB Type Physician Office
Facility Name PRIMARY HEALTH MEDICAL GROUP - OVERLAND
Street 8971 W OVERLAND RD
City BOISE
State ID
ZIP 83709
Phone 208 378-4288
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/9/2025
Certificate Expiration Date 9/8/2027
Facility Type Physician Office
Lab Director CYRUS VANIA

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