13D1038653 CLIA NUMBER - POCATELLO MEDICAL PARTNERS

Laboratory Demographics

  • CLIA Code: 13D1038653
  • Facility Name: POCATELLO MEDICAL PARTNERS
  • Facility Address: 333 KNUDSEN BOULEVARD
    CHUBBUCK, ID
    ZIP 83202
  • Facility Phone: 208 776-4732
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: HIRA SIKTEL
  • NPI Number: 1275577025
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D1038653
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name POCATELLO MEDICAL PARTNERS
Street 333 KNUDSEN BOULEVARD
City CHUBBUCK
State ID
ZIP 83202
Phone 208 776-4732
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director HIRA SIKTEL

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