13D2058335 CLIA NUMBER - KAYLOR FAMLY MEDICINE

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Laboratory Demographics

CLIA Number: 13D2058335

Facility Name: KAYLOR FAMLY MEDICINE

Facility Address:
2536 N STOKESBERRY PL
MERIDIAN, ID
ZIP 83646
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Facility Phone Number: 208 855-0880

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1891355392

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	13D2058335
LAB Type	Physician Office
Facility Name	KAYLOR FAMLY MEDICINE
Street	2536 N STOKESBERRY PL
City	MERIDIAN
State	ID
ZIP	83646
Phone	208 855-0880
CertificateType	3
CertificateEffectiveDate	5/6/2023
CertificateExpirationDate	5/5/2025
FacilityType	PPMP

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