13D2191977 CLIA NUMBER - PRIMARY HEALTH MEDICAL GROUP-KUNA

Laboratory Demographics

  • CLIA Code: 13D2191977
  • Facility Name: PRIMARY HEALTH MEDICAL GROUP-KUNA
  • Facility Address: 1474 N MERIDIAN RD
    KUNA, ID
    ZIP 83634
  • Facility Phone: 208 809-2885
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DEREK HAMBLIN
  • NPI Number: 1780298430
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 13D2191977
LAB Type Physician Office
Facility Name PRIMARY HEALTH MEDICAL GROUP-KUNA
Street 1474 N MERIDIAN RD
City KUNA
State ID
ZIP 83634
Phone 208 809-2885
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 9/3/2024
Certificate Expiration Date 9/2/2026
Facility Type Physician Office
Lab Director DEREK HAMBLIN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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