13D2192418 CLIA NUMBER - TABLE ROCK SENIOR LIVING AT BARBER STATION

Laboratory Demographics

  • CLIA Code: 13D2192418
  • Facility Name: TABLE ROCK SENIOR LIVING AT BARBER STATION
  • Facility Address: 3266 E BARBER VALLEY DR
    BOISE, ID
    ZIP 83716
  • Facility Phone: 208 616-1150
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MATTHEW JOHNSON
  • NPI Number: 1477016012
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 13D2192418
LAB Type Assisted Living Facility
Facility Name TABLE ROCK SENIOR LIVING AT BARBER STATION
Street 3266 E BARBER VALLEY DR
City BOISE
State ID
ZIP 83716
Phone 208 616-1150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2024
Certificate Expiration Date 9/9/2026
Facility Type Assisted Living Facility
Lab Director MATTHEW JOHNSON

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