13D2112426 CLIA NUMBER - MAGIC VALLEY MEDICINE

Laboratory Demographics

  • CLIA Code: 13D2112426
  • Facility Name: MAGIC VALLEY MEDICINE
  • Facility Address: 844 WASHINGTON ST NORTH STE 400
    TWIN FALLS, ID
    ZIP 83301
  • Facility Phone: 208 734-0000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAMUEL BARKER
  • NPI Number: 1174939383
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 13D2112426
LAB Type Physician Office
Facility Name MAGIC VALLEY MEDICINE
Street 844 WASHINGTON ST NORTH STE 400
City TWIN FALLS
State ID
ZIP 83301
Phone 208 734-0000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2024
Certificate Expiration Date 4/27/2026
Facility Type Physician Office
Lab Director SAMUEL BARKER

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