13D2053554 CLIA NUMBER - SKYLINE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 13D2053554
  • Facility Name: SKYLINE SURGERY CENTER
  • Facility Address: 285 VISTA DRIVE
    POCATELLO, ID
    ZIP 83201
  • Facility Phone: 208 478-1704
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DEB MEYER
  • NPI Number: 1851552483
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D2053554
LAB Type Ambulatory Surgery Center
Facility Name SKYLINE SURGERY CENTER
Street 285 VISTA DRIVE
City POCATELLO
State ID
ZIP 83201
Phone 208 478-1704
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Ambulatory Surgery Center
Lab Director DEB MEYER

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This page was last updated on: 6/4/2025