13D1046352 CLIA NUMBER - IDAHO SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 13D1046352
  • Facility Name: IDAHO SURGERY CENTER
  • Facility Address: 2115 MEDICAL WAY
    CALDWELL, ID
    ZIP 83605
  • Facility Phone: 208 453-8668
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RICHARD AUGUSTUS
  • NPI Number: 1386614519
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 13D1046352
LAB Type Ambulatory Surgery Center
Facility Name IDAHO SURGERY CENTER
Street 2115 MEDICAL WAY
City CALDWELL
State ID
ZIP 83605
Phone 208 453-8668
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Ambulatory Surgery Center
Lab Director RICHARD AUGUSTUS

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