13D0987656 CLIA NUMBER - POWER COUNTY FAMILY CLINIC

Laboratory Demographics

CLIA Number: 13D0987656

Facility Name: POWER COUNTY FAMILY CLINIC

Facility Address:
502 TYHEE AVE
AMERICAN FALLS, ID
ZIP 83211
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Facility Phone Number: 208 226-1057

Facility Type: Rural Health Clinic

Certificate Type: Microscopy

NPI Number: 1992239172

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	13D0987656
LAB Type	Rural Health Clinic
Facility Name	POWER COUNTY FAMILY CLINIC
Street	502 TYHEE AVE
City	AMERICAN FALLS
State	ID
ZIP	83211
Phone	208 226-1057
CertificateType	3
CertificateEffectiveDate	4/11/2023
CertificateExpirationDate	4/10/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024