13D0969818 CLIA NUMBER - IDAHO FALLS PEDIATRICS

Laboratory Demographics

  • CLIA Code: 13D0969818
  • Facility Name: IDAHO FALLS PEDIATRICS
  • Facility Address: 3067 EAGLE DR
    AMMON, ID
    ZIP 83406
  • Facility Phone: 208 522-4600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SCOTT SMITH
  • NPI Number: 1366560971
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 13D0969818
LAB Type Physician Office
Facility Name IDAHO FALLS PEDIATRICS
Street 3067 EAGLE DR
City AMMON
State ID
ZIP 83406
Phone 208 522-4600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Physician Office
Lab Director SCOTT SMITH

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