13D2050756 CLIA NUMBER - IDAHO FALLS INFECTIOUS DISEASES

Laboratory Demographics

  • CLIA Code: 13D2050756
  • Facility Name: IDAHO FALLS INFECTIOUS DISEASES
  • Facility Address: 3614 WASHINGTON PARKWAY
    IDAHO FALLS, ID
    ZIP 83404
  • Facility Phone: 208 535-8406
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARLES O. GARRISON
  • NPI Number: 1699019182
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 13D2050756
LAB Type Physician Office
Facility Name IDAHO FALLS INFECTIOUS DISEASES
Street 3614 WASHINGTON PARKWAY
City IDAHO FALLS
State ID
ZIP 83404
Phone 208 535-8406
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2024
Certificate Expiration Date 2/12/2026
Facility Type Physician Office
Lab Director CHARLES O. GARRISON

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