13D2075881 CLIA NUMBER - EXODUS PAIN CLINIC

Laboratory Demographics

  • CLIA Code: 13D2075881
  • Facility Name: EXODUS PAIN CLINIC
  • Facility Address: 987 S ALLANTE PLACE
    BOISE, ID
    ZIP 83709
  • Facility Phone: 208 947-7246
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DANIEL MARSH
  • NPI Number: 1366849572
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D2075881
LAB Type Physician Office
Facility Name EXODUS PAIN CLINIC
Street 987 S ALLANTE PLACE
City BOISE
State ID
ZIP 83709
Phone 208 947-7246
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Physician Office
Lab Director DANIEL MARSH

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