13D2156813 CLIA NUMBER - EAGLE ROCK SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 13D2156813
  • Facility Name: EAGLE ROCK SURGERY CENTER
  • Facility Address: 3302 VALENCIA DR STE 101A
    IDAHO FALLS, ID
    ZIP 83404
  • Facility Phone: 208 557-2576
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SCOTT TAYLOR
  • NPI Number: 1710053756
  • Taxonomy: 2084N0400X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 13D2156813
LAB Type Ambulatory Surgery Center
Facility Name EAGLE ROCK SURGERY CENTER
Street 3302 VALENCIA DR STE 101A
City IDAHO FALLS
State ID
ZIP 83404
Phone 208 557-2576
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/6/2025
Certificate Expiration Date 5/5/2027
Facility Type Ambulatory Surgery Center
Lab Director SCOTT TAYLOR

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