13D0954249 CLIA NUMBER - FAMILY MEDICINE HEALTH CENTER -IDAHO

Laboratory Demographics

  • CLIA Code: 13D0954249
  • Facility Name: FAMILY MEDICINE HEALTH CENTER -IDAHO
  • Facility Address: 325 IDAHO STREET
    BOISE, ID
    ZIP 83704
  • Facility Phone: 208 514-2529
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: PERRY BROWN
  • NPI Number: 1891047791
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D0954249
LAB Type Federally Qualified Health Center
Facility Name FAMILY MEDICINE HEALTH CENTER -IDAHO
Street 325 IDAHO STREET
City BOISE
State ID
ZIP 83704
Phone 208 514-2529
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2025
Certificate Expiration Date 9/15/2027
Facility Type Federally Qualified Health Center
Lab Director PERRY BROWN

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