13D2214851 CLIA NUMBER - CENTRAL IDAHO COUNSELING

Laboratory Demographics

  • CLIA Code: 13D2214851
  • Facility Name: CENTRAL IDAHO COUNSELING
  • Facility Address: 106 E PARK ST STE 100
    MCCALL, ID
    ZIP 83638
  • Facility Phone: 208 634-2962
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ERIC A. MIKKELSEN
  • NPI Number: 1275944498
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 13D2214851
LAB Type Practitioner Other
Facility Name CENTRAL IDAHO COUNSELING
Street 106 E PARK ST STE 100
City MCCALL
State ID
ZIP 83638
Phone 208 634-2962
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/25/2025
Certificate Expiration Date 2/24/2027
Facility Type Practitioner Other
Lab Director ERIC A. MIKKELSEN

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