13D0870437 CLIA NUMBER - MACHEN FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 13D0870437
  • Facility Name: MACHEN FAMILY MEDICINE
  • Facility Address: 3500 POTOMAC WAY STE 100
    IDAHO FALLS, ID
    ZIP 83404
  • Facility Phone: (208) 522-7666
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SHANE G. MACHEN
  • NPI Number: 1013204445
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D0870437
LAB Type Physician Office
Facility Name MACHEN FAMILY MEDICINE
Street 3500 POTOMAC WAY STE 100
City IDAHO FALLS
State ID
ZIP 83404
Phone 2085227666
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 6/13/2025
Certificate Expiration Date 6/12/2027
Facility Type Physician Office
Lab Director SHANE G. MACHEN

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This page was last updated on: 5/18/2026