13D0910691 CLIA NUMBER - PRIMARY HEALTH MEDICAL GROUP - CALDWELL

Laboratory Demographics

CLIA Number: 13D0910691

Facility Name: PRIMARY HEALTH MEDICAL GROUP - CALDWELL

Facility Address:
4815 CLEVELAND BLVD
CALDWELL, ID
ZIP 83605
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Facility Phone Number: 208 455-3545

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1629214960

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	13D0910691
LAB Type	Physician Office
Facility Name	PRIMARY HEALTH MEDICAL GROUP - CALDWELL
Street	4815 CLEVELAND BLVD
City	CALDWELL
State	ID
ZIP	83605
Phone	208 455-3545
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