13D2021272 CLIA NUMBER - MOUNTAIN HOME CBOC

Laboratory Demographics

  • CLIA Code: 13D2021272
  • Facility Name: MOUNTAIN HOME CBOC
  • Facility Address: 815 NORTH 6TH STREET EAST
    MOUNTAIN HOME, ID
    ZIP 83647
  • Facility Phone: 208 580-2001
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: RONALD SLAUGHTER
  • NPI Number: 1134251507
  • Taxonomy: 261QP2000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D2021272
LAB Type Community Clinic
Facility Name MOUNTAIN HOME CBOC
Street 815 NORTH 6TH STREET EAST
City MOUNTAIN HOME
State ID
ZIP 83647
Phone 208 580-2001
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 3/10/2011
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director RONALD SLAUGHTER

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