13D1040809 CLIA NUMBER - UPPER VALLEY FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 13D1040809
  • Facility Name: UPPER VALLEY FAMILY PRACTICE
  • Facility Address: 32 W 1ST S
    REXBURG, ID
    ZIP 83440
  • Facility Phone: 208 356-8883
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JEFFREY G. HOPKIN
  • NPI Number: 1922237874
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D1040809
LAB Type Physician Office
Facility Name UPPER VALLEY FAMILY PRACTICE
Street 32 W 1ST S
City REXBURG
State ID
ZIP 83440
Phone 208 356-8883
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 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Physician Office
Lab Director JEFFREY G. HOPKIN

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