13D2103854 CLIA NUMBER - EMMETT FAMILY MEDICINE & DIRECT PRIMARY CARE

Laboratory Demographics

CLIA Number: 13D2103854

Facility Name: EMMETT FAMILY MEDICINE & DIRECT PRIMARY CARE

Facility Address:
2001 E QUAIL RUN RD
EMMETT, ID
ZIP 83617
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Facility Phone Number: 208 365-7131

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1447629555

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	13D2103854
LAB Type	Community Clinic
Facility Name	EMMETT FAMILY MEDICINE & DIRECT PRIMARY CARE
Street	2001 E QUAIL RUN RD
City	EMMETT
State	ID
ZIP	83617
Phone	208 365-7131
CertificateType	3
CertificateEffectiveDate	10/21/2023
CertificateExpirationDate	10/20/2025
FacilityType	PPMP

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