13D0970668 CLIA NUMBER - IDAHO SURGICENTER INC

Laboratory Demographics

  • CLIA Code: 13D0970668
  • Facility Name: IDAHO SURGICENTER INC
  • Facility Address: 1157 CALL CREEK PL
    POCATELLO, ID
    ZIP 83201
  • Facility Phone: 208 238-6337
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DARIN GAMBLES
  • NPI Number: 1992759930
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 13D0970668
LAB Type Ambulatory Surgery Center
Facility Name IDAHO SURGICENTER INC
Street 1157 CALL CREEK PL
City POCATELLO
State ID
ZIP 83201
Phone 208 238-6337
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2024
Certificate Expiration Date 2/21/2026
Facility Type Ambulatory Surgery Center
Lab Director DARIN GAMBLES

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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