13D1096028 CLIA NUMBER - ALPINE DERMATOLOGY CLINIC

Laboratory Demographics

  • CLIA Code: 13D1096028
  • Facility Name: ALPINE DERMATOLOGY CLINIC
  • Facility Address: 1049 SUMMERS DR
    REXBURG, ID
    ZIP 83440
  • Facility Phone: 208 359-4841
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DANIEL R. MARSHALL
  • NPI Number: 1588802391
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D1096028
LAB Type Physician Office
Facility Name ALPINE DERMATOLOGY CLINIC
Street 1049 SUMMERS DR
City REXBURG
State ID
ZIP 83440
Phone 208 359-4841
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 10/19/2023
Certificate Expiration Date 10/18/2025
Facility Type Physician Office
Lab Director DANIEL R. MARSHALL

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