13D2210857 CLIA NUMBER - EAST FALLS SPECIALTY CLINIC-EP CARDIOLOGY

Laboratory Demographics

  • CLIA Code: 13D2210857
  • Facility Name: EAST FALLS SPECIALTY CLINIC-EP CARDIOLOGY
  • Facility Address: 3200 CHANNING WAY STE 205
    IDAHO FALLS, ID
    ZIP 83404
  • Facility Phone: 208 535-4580
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JERRY RYERSE
  • NPI Number: 1902841893
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 13D2210857
LAB Type Physician Office
Facility Name EAST FALLS SPECIALTY CLINIC-EP CARDIOLOGY
Street 3200 CHANNING WAY STE 205
City IDAHO FALLS
State ID
ZIP 83404
Phone 208 535-4580
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Physician Office
Lab Director JERRY RYERSE

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