13D2112996 CLIA NUMBER - PRIMARY HEALTH MEDICAL GROUP-GARDEN CITY

Laboratory Demographics

CLIA Number: 13D2112996

Facility Name: PRIMARY HEALTH MEDICAL GROUP-GARDEN CITY

Facility Address:
5601 W CHINDEN BLVD
BOISE, ID
ZIP 83714
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Facility Phone Number: 208 809-2865

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1841646007

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	13D2112996
LAB Type	Physician Office
Facility Name	PRIMARY HEALTH MEDICAL GROUP-GARDEN CITY
Street	5601 W CHINDEN BLVD
City	BOISE
State	ID
ZIP	83714
Phone	208 809-2865
CertificateType	3
CertificateEffectiveDate	5/13/2024
CertificateExpirationDate	5/12/2026
FacilityType	PPMP

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