13D2171440 CLIA NUMBER - FRONTIER PEDIATRIC PARTNERS PLLC

Laboratory Demographics

  • CLIA Code: 13D2171440
  • Facility Name: FRONTIER PEDIATRIC PARTNERS PLLC
  • Facility Address: 1502 LOCUST ST N STE 700
    TWIN FALLS, ID
    ZIP 83301
  • Facility Phone: 208 595-5095
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JENNIFER S. JORGENSEN
  • NPI Number: 1780146316
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 13D2171440
LAB Type Physician Office
Facility Name FRONTIER PEDIATRIC PARTNERS PLLC
Street 1502 LOCUST ST N STE 700
City TWIN FALLS
State ID
ZIP 83301
Phone 208 595-5095
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 8/30/2025
Certificate Expiration Date 8/29/2027
Facility Type Physician Office
Lab Director JENNIFER S. JORGENSEN

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