13D0966535 CLIA NUMBER - OSBURN FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 13D0966535
  • Facility Name: OSBURN FAMILY MEDICINE
  • Facility Address: 801 E MULLAN AVE
    OSBURN, ID
    ZIP 83849
  • Facility Phone: 208 556-4803
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANTHONY BRANZ
  • NPI Number: 1821142530
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D0966535
LAB Type Physician Office
Facility Name OSBURN FAMILY MEDICINE
Street 801 E MULLAN AVE
City OSBURN
State ID
ZIP 83849
Phone 208 556-4803
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/19/2023
Certificate Expiration Date 10/18/2025
Facility Type Physician Office
Lab Director ANTHONY BRANZ

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This page was last updated on: 3/20/2025