13D1047004 CLIA NUMBER - WEST FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 13D1047004
  • Facility Name: WEST FAMILY MEDICINE
  • Facility Address: 1133 CALL CREEK PL #A
    POCATELLO, ID
    ZIP 83201
  • Facility Phone: (208) 232-1000
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRANDON A. WEST
  • NPI Number: 1780808022
  • Taxonomy: 207QA0000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D1047004
LAB Type Physician Office
Facility Name WEST FAMILY MEDICINE
Street 1133 CALL CREEK PL #A
City POCATELLO
State ID
ZIP 83201
Phone 2082321000
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 10/25/2025
Certificate Expiration Date 10/24/2027
Facility Type Physician Office
Lab Director BRANDON A. WEST

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This page was last updated on: 5/18/2026