13D2131475 CLIA NUMBER - BOISE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 13D2131475
  • Facility Name: BOISE DERMATOLOGY
  • Facility Address: 3109 S MERIDIAN RD
    MERIDIAN, ID
    ZIP 83642
  • Facility Phone: 208 888-0660
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NAOMI BROOKS
  • NPI Number: 1417495615
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 13D2131475
LAB Type Physician Office
Facility Name BOISE DERMATOLOGY
Street 3109 S MERIDIAN RD
City MERIDIAN
State ID
ZIP 83642
Phone 208 888-0660
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2025
Certificate Expiration Date 7/14/2027
Facility Type Physician Office
Lab Director NAOMI BROOKS

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