13D2176990 CLIA NUMBER - MMMEDICAL GROUP LLC DBA RIVER FAMILY HEALTH

Laboratory Demographics

  • CLIA Code: 13D2176990
  • Facility Name: MMMEDICAL GROUP LLC DBA RIVER FAMILY HEALTH
  • Facility Address: 801 N STILSON RD STE 100
    BOISE, ID
    ZIP 83703
  • Facility Phone: 208 332-4540
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KARA E. DELACY NP-C
  • NPI Number: 1548890460
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 13D2176990
LAB Type Practitioner Other
Facility Name MMMEDICAL GROUP LLC DBA RIVER FAMILY HEALTH
Street 801 N STILSON RD STE 100
City BOISE
State ID
ZIP 83703
Phone 208 332-4540
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/31/2023
Certificate Expiration Date 12/30/2025
Facility Type Practitioner Other
Lab Director KARA E. DELACY NP-C

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