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13D1041322 CLIA NUMBER - ORTHOPEDIC HEALTH CARE CLINIC

Laboratory Demographics

CLIA Number: 13D1041322

Facility Name: ORTHOPEDIC HEALTH CARE CLINIC

Facility Address:
1789 S BROADWAY AVE STE 100
BOISE, ID
ZIP 83706
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Facility Phone Number: 208 287-0203

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1013955178

Taxonomy: 207XX0005X - Orthopaedic Surgery
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

CLIA Record

Field Name Field Value
CLIA Number 13D1041322
LAB Type Physician Office
Facility Name ORTHOPEDIC HEALTH CARE CLINIC
Street 1789 S BROADWAY AVE STE 100
City BOISE
State ID
ZIP 83706
Phone 208 287-0203
CertificateType 4
CertificateEffectiveDate 5/31/2023
CertificateExpirationDate 5/30/2025
FacilityType Waiver

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