13D0935096 CLIA NUMBER - PRIMARY CARE SPECIALISTS

Laboratory Demographics

  • CLIA Code: 13D0935096
  • Facility Name: PRIMARY CARE SPECIALISTS
  • Facility Address: 110 VISTA DR
    POCATELLO, ID
    ZIP 83201
  • Facility Phone: 208 234-2300
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MARK MANSFIELD
  • NPI Number: 1508875881
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D0935096
LAB Type Physician Office
Facility Name PRIMARY CARE SPECIALISTS
Street 110 VISTA DR
City POCATELLO
State ID
ZIP 83201
Phone 208 234-2300
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 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Physician Office
Lab Director MARK MANSFIELD

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