13D2212281 CLIA NUMBER - IDAHO CONCIERGE MEDICINE LLC

Laboratory Demographics

  • CLIA Code: 13D2212281
  • Facility Name: IDAHO CONCIERGE MEDICINE LLC
  • Facility Address: 11696 W GABRIELLE CT
    BOISE, ID
    ZIP 83713
  • Facility Phone: 208 314-1325
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: SABRINA BOJO
  • NPI Number: 1013712330
  • Taxonomy: 207QA0505X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D2212281
LAB Type Home Health Agency
Facility Name IDAHO CONCIERGE MEDICINE LLC
Street 11696 W GABRIELLE CT
City BOISE
State ID
ZIP 83713
Phone 208 314-1325
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Home Health Agency
Lab Director SABRINA BOJO

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