13D0890001 CLIA NUMBER - IDAHO STATE VETERANS HOME BOISE

Laboratory Demographics

  • CLIA Code: 13D0890001
  • Facility Name: IDAHO STATE VETERANS HOME BOISE
  • Facility Address: 320 COLLINS RD
    BOISE, ID
    ZIP 83702
  • Facility Phone: 208 780-1600
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RICK HOLLOWAY
  • NPI Number: 1285624627
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 13D0890001
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name IDAHO STATE VETERANS HOME BOISE
Street 320 COLLINS RD
City BOISE
State ID
ZIP 83702
Phone 208 780-1600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2024
Certificate Expiration Date 8/9/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director RICK HOLLOWAY

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This page was last updated on: 6/4/2025