13D0870961 CLIA NUMBER - HAYDEN LAKE FAMILY PHYSICIANS

Laboratory Demographics

  • CLIA Code: 13D0870961
  • Facility Name: HAYDEN LAKE FAMILY PHYSICIANS
  • Facility Address: 8181 N CORNERSTONE DR
    HAYDEN LAKE, ID
    ZIP 83835
  • Facility Phone: 208 772-0785
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: BRAD BROSOSKY
  • NPI Number: 1639152739
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D0870961
LAB Type Physician Office
Facility Name HAYDEN LAKE FAMILY PHYSICIANS
Street 8181 N CORNERSTONE DR
City HAYDEN LAKE
State ID
ZIP 83835
Phone 208 772-0785
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/13/2024
Certificate Expiration Date 6/12/2026
Facility Type Physician Office
Lab Director BRAD BROSOSKY

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