13D2058933 CLIA NUMBER - BEAR RIVER CHIROPRACTIC

Laboratory Demographics

  • CLIA Code: 13D2058933
  • Facility Name: BEAR RIVER CHIROPRACTIC
  • Facility Address: 45 W CENTER ST
    SODA SPRINGS, ID
    ZIP 83276
  • Facility Phone: 208 547-4518
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JARED M. SHELTON
  • NPI Number: 1760617765
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 13D2058933
LAB Type Physician Office
Facility Name BEAR RIVER CHIROPRACTIC
Street 45 W CENTER ST
City SODA SPRINGS
State ID
ZIP 83276
Phone 208 547-4518
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2025
Certificate Expiration Date 5/14/2027
Facility Type Physician Office
Lab Director JARED M. SHELTON

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