13D2212395 CLIA NUMBER - POWER COUNTY AMBULANCE DISTRICT

Laboratory Demographics

CLIA Number: 13D2212395

Facility Name: POWER COUNTY AMBULANCE DISTRICT

Facility Address:
560 N OREGON TRAIL RD
AMERICAN FALLS, ID
ZIP 83211
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Facility Phone Number: 208 226-5605

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1881691491

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	13D2212395
LAB Type	Ambulance
Facility Name	POWER COUNTY AMBULANCE DISTRICT
Street	560 N OREGON TRAIL RD
City	AMERICAN FALLS
State	ID
ZIP	83211
Phone	208 226-5605
CertificateType	4
CertificateEffectiveDate	2/4/2023
CertificateExpirationDate	2/3/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024