13D1095117 CLIA NUMBER - TRIVIUM LIFE SERVICES

Laboratory Demographics

  • CLIA Code: 13D1095117
  • Facility Name: TRIVIUM LIFE SERVICES
  • Facility Address: 8950 W EMERALD ST #178
    BOISE, ID
    ZIP 83704
  • Facility Phone: 208 376-7083
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: KERSONDRA HOOD
  • NPI Number: 1194962829
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D1095117
LAB Type Comp. Outpatient Rehab Facility
Facility Name TRIVIUM LIFE SERVICES
Street 8950 W EMERALD ST #178
City BOISE
State ID
ZIP 83704
Phone 208 376-7083
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director KERSONDRA HOOD

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