13D1096966 CLIA NUMBER - PHYSICIANS IMMEDIATE CARE CENTER

Laboratory Demographics

  • CLIA Code: 13D1096966
  • Facility Name: PHYSICIANS IMMEDIATE CARE CENTER
  • Facility Address: 134 W CHUBBUCK RD
    CHUBBUCK, ID
    ZIP 83202
  • Facility Phone: 208 237-7911
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: WARREN WILLEY
  • NPI Number: 1023392800
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 13D1096966
LAB Type Physician Office
Facility Name PHYSICIANS IMMEDIATE CARE CENTER
Street 134 W CHUBBUCK RD
City CHUBBUCK
State ID
ZIP 83202
Phone 208 237-7911
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 5/26/2024
Certificate Expiration Date 5/25/2026
Facility Type Physician Office
Lab Director WARREN WILLEY

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