13D2006945 CLIA NUMBER - PROMONTORY POINT REHABILITATION

Laboratory Demographics

  • CLIA Code: 13D2006945
  • Facility Name: PROMONTORY POINT REHABILITATION
  • Facility Address: 3909 S 25TH E
    AMMON, ID
    ZIP 83406
  • Facility Phone: 208 528-4000
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DEIDRA ROMERO
  • NPI Number: 1760719934
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 13D2006945
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PROMONTORY POINT REHABILITATION
Street 3909 S 25TH E
City AMMON
State ID
ZIP 83406
Phone 208 528-4000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2024
Certificate Expiration Date 5/4/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DEIDRA ROMERO

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