13D0674117 CLIA NUMBER - ST LUKE'S CLINIC - UROLOGY CALDWELL

Laboratory Demographics

CLIA Number: 13D0674117

Facility Name: ST LUKE'S CLINIC - UROLOGY CALDWELL

Facility Address:
1906 FAIRVIEW AVE STE 350
CALDWELL, ID
ZIP 83605
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Facility Phone Number: (208) 454-9181

Facility Type: COMMUNITY CLINIC

Certificate Type: Microscopy

NPI Number: 1306804356

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	13D0674117
LAB Type	COMMUNITY CLINIC
Facility Name	ST LUKE'S CLINIC - UROLOGY CALDWELL
Street	1906 FAIRVIEW AVE STE 350
City	CALDWELL
State	ID
ZIP	83605
Phone	(208) 454-9181

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This page was last updated on: 5/11/2023