13D0700359 CLIA NUMBER - BANNOCK COUNTY AMBULANCE

Laboratory Demographics

  • CLIA Code: 13D0700359
  • Facility Name: BANNOCK COUNTY AMBULANCE
  • Facility Address: 408 E WHITMAN ST
    POCATELLO, ID
    ZIP 83201
  • Facility Phone: 208 234-6200
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: CURTIS SANDY
  • NPI Number: 1962485946
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 13D0700359
LAB Type Other
Facility Name BANNOCK COUNTY AMBULANCE
Street 408 E WHITMAN ST
City POCATELLO
State ID
ZIP 83201
Phone 208 234-6200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Other
Lab Director CURTIS SANDY

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