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

Laboratory Demographics

  • CLIA Code: 13D2112996
  • Facility Name: PRIMARY HEALTH MEDICAL GROUP-GARDEN CITY
  • Facility Address: 5601 W CHINDEN BLVD
    BOISE, ID
    ZIP 83714
  • Facility Phone: 208 809-2865
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LEE PARSONS
  • NPI Number: 1841646007
  • Taxonomy: 207Q00000X - Family Medicine

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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
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 5/13/2024
Certificate Expiration Date 5/12/2026
Facility Type Physician Office
Lab Director LEE PARSONS

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