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13D0861110 CLIA NUMBER - PRIMARY HEALTH MEDICAL GROUP - MERIDIAN

Laboratory Demographics

CLIA Number: 13D0861110

Facility Name: PRIMARY HEALTH MEDICAL GROUP - MERIDIAN

Facility Address:
1648 NW 1ST STREET
MERIDIAN, ID
ZIP 83642
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Facility Phone Number: 208 888-9393

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1407092794

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 13D0861110
LAB Type Physician Office
Facility Name PRIMARY HEALTH MEDICAL GROUP - MERIDIAN
Street 1648 NW 1ST STREET
City MERIDIAN
State ID
ZIP 83642
Phone 208 888-9393
CertificateType 3
CertificateEffectiveDate 9/9/2023
CertificateExpirationDate 9/8/2025
FacilityType PPMP

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