13D2013219 CLIA NUMBER - TREASURE VALLEY GASTROENTEROLOGY

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Laboratory Demographics

CLIA Number: 13D2013219

Facility Name: TREASURE VALLEY GASTROENTEROLOGY

Facility Address:
222 W IOWA AVE #A
NAMPA, ID
ZIP 83686
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Facility Phone Number: 208 467-3432

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1194817023

Taxonomy: 207RG0100X - Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

CLIA Record

Field Name	Field Value
CLIA Number	13D2013219
LAB Type	Physician Office
Facility Name	TREASURE VALLEY GASTROENTEROLOGY
Street	222 W IOWA AVE #A
City	NAMPA
State	ID
ZIP	83686
Phone	208 467-3432
CertificateType	4
CertificateEffectiveDate	9/16/2022
CertificateExpirationDate	9/15/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024