13D0938420 CLIA NUMBER - DOCTORS CLINIC OF ELMORE COUNTY

Laboratory Demographics

CLIA Number: 13D0938420

Facility Name: DOCTORS CLINIC OF ELMORE COUNTY

Facility Address:
2000 AMERICAN LEGION BLVD
MOUNTAIN HOME, ID
ZIP 83647
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Facility Phone Number: 208 587-1500

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1063578664

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	13D0938420
LAB Type	Physician Office
Facility Name	DOCTORS CLINIC OF ELMORE COUNTY
Street	2000 AMERICAN LEGION BLVD
City	MOUNTAIN HOME
State	ID
ZIP	83647
Phone	208 587-1500
CertificateType	3
CertificateEffectiveDate	7/10/2023
CertificateExpirationDate	7/9/2025
FacilityType	PPMP

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