13D2102904 CLIA NUMBER - PRIMARY HEALTH MEDICAL GROUP - ORCHARD

Laboratory Demographics

  • CLIA Code: 13D2102904
  • Facility Name: PRIMARY HEALTH MEDICAL GROUP - ORCHARD
  • Facility Address: 4971 W OVERLAND RD
    BOISE, ID
    ZIP 83705
  • Facility Phone: (208) 472-5050
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: AMBER VANIA
  • NPI Number: 1568608800
  • Taxonomy: 261QM1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 13D2102904
LAB Type Physician Office
Facility Name PRIMARY HEALTH MEDICAL GROUP - ORCHARD
Street 4971 W OVERLAND RD
City BOISE
State ID
ZIP 83705
Phone 2084725050
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/1/2025
Certificate Expiration Date 9/30/2027
Facility Type Physician Office
Lab Director AMBER VANIA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 5/18/2026