13D0944869 CLIA NUMBER - MV POCATELLO ENT

Laboratory Demographics

  • CLIA Code: 13D0944869
  • Facility Name: MV POCATELLO ENT
  • Facility Address: 333 N 18TH AVE #B3
    POCATELLO, ID
    ZIP 83201
  • Facility Phone: 208 232-2146
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KRAIG C. MCGEE
  • NPI Number: 1154801595
  • Taxonomy: 207Y00000X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 13D0944869
LAB Type Physician Office
Facility Name MV POCATELLO ENT
Street 333 N 18TH AVE #B3
City POCATELLO
State ID
ZIP 83201
Phone 208 232-2146
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Physician Office
Lab Director KRAIG C. MCGEE

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