13D0522232 CLIA NUMBER - SHOSHONE MEDICAL CENTER

Laboratory Demographics

CLIA Number: 13D0522232

Facility Name: SHOSHONE MEDICAL CENTER

Facility Address:
25 JACOBS GULCH RD
KELLOGG, ID
ZIP 83837
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Facility Phone Number: 208 784-1221

Facility Type: Hospital

Certificate Type: Certificate of Compliance

NPI Number: 1487272399

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 13D0522232
LAB Type Hospital
Facility Name SHOSHONE MEDICAL CENTER
Street 25 JACOBS GULCH RD
City KELLOGG
State ID
ZIP 83837
Phone 208 784-1221
CertificateType 2
CertificateEffectiveDate 6/19/2023
CertificateExpirationDate 6/18/2025
FacilityType Compliance

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