13D1098212 CLIA NUMBER - CANYON COUNTY AMBULANCE DISTRICT

Laboratory Demographics

  • CLIA Code: 13D1098212
  • Facility Name: CANYON COUNTY AMBULANCE DISTRICT
  • Facility Address: 6116 GRAYE LANE
    CALDWELL, ID
    ZIP 83607
  • Facility Phone: 208 795-6920
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: KARI PETERSON
  • NPI Number: 1114926151
  • Taxonomy: 341600000X - Ambulance

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 13D1098212
LAB Type Ambulance
Facility Name CANYON COUNTY AMBULANCE DISTRICT
Street 6116 GRAYE LANE
City CALDWELL
State ID
ZIP 83607
Phone 208 795-6920
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Ambulance
Lab Director KARI PETERSON

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