13D0926381 CLIA NUMBER - COMMUNITY CARE OF CHANNING WAY

Laboratory Demographics

  • CLIA Code: 13D0926381
  • Facility Name: COMMUNITY CARE OF CHANNING WAY
  • Facility Address: 2725 CHANNING WAY
    IDAHO FALLS, ID
    ZIP 83404
  • Facility Phone: 208 525-8448
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: TROY R. BRUMFIELD
  • NPI Number: 1003088782
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D0926381
LAB Type Physician Office
Facility Name COMMUNITY CARE OF CHANNING WAY
Street 2725 CHANNING WAY
City IDAHO FALLS
State ID
ZIP 83404
Phone 208 525-8448
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 2/6/2024
Certificate Expiration Date 2/5/2026
Facility Type Physician Office
Lab Director TROY R. BRUMFIELD

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