13D0935092 CLIA NUMBER - GEM STATE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 13D0935092
  • Facility Name: GEM STATE DERMATOLOGY
  • Facility Address: 388 E PARKCENTER BLVD
    BOISE, ID
    ZIP 83706
  • Facility Phone: 208 424-9101
  • Facility Type: Practitioner Other
  • Facility Type: Certificate of Compliance
  • Lab Director: STEVEN M. MINGS
  • NPI Number: 1912040270
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 13D0935092
LAB Type Practitioner Other
Facility Name GEM STATE DERMATOLOGY
Street 388 E PARKCENTER BLVD
City BOISE
State ID
ZIP 83706
Phone 208 424-9101
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 5/4/2024
Certificate Expiration Date 5/3/2026
Facility Type Practitioner Other
Lab Director STEVEN M. MINGS

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