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13D0922902 CLIA NUMBER - PRIMARY HEALTH MEDICAL GROUP-CROSSROADS/PED

Laboratory Demographics

CLIA Number: 13D0922902

Facility Name: PRIMARY HEALTH MEDICAL GROUP-CROSSROADS/PED

Facility Address:
3280 E LANARK DR
MERIDIAN, ID
ZIP 83642
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Facility Phone Number: 208 895-8670

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1780820076

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 13D0922902
LAB Type Physician Office
Facility Name PRIMARY HEALTH MEDICAL GROUP-CROSSROADS/PED
Street 3280 E LANARK DR
City MERIDIAN
State ID
ZIP 83642
Phone 208 895-8670
CertificateType 3
CertificateEffectiveDate 8/18/2022
CertificateExpirationDate 8/17/2024
FacilityType PPMP

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