13D2159390 CLIA NUMBER - TREASURE VALLEY UROLOGY PLLC

Laboratory Demographics

  • CLIA Code: 13D2159390
  • Facility Name: TREASURE VALLEY UROLOGY PLLC
  • Facility Address: 8854 W EMEREALD ST STE 180
    BOISE, ID
    ZIP 83704
  • Facility Phone: 208 229-9009
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JARED HEINER
  • NPI Number: 1699242123
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 13D2159390
LAB Type Physician Office
Facility Name TREASURE VALLEY UROLOGY PLLC
Street 8854 W EMEREALD ST STE 180
City BOISE
State ID
ZIP 83704
Phone 208 229-9009
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 12/18/2024
Certificate Expiration Date 12/17/2026
Facility Type Physician Office
Lab Director JARED HEINER

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