13D2226590 CLIA NUMBER - IDAHO CHIROPRACTIC GROUP

Laboratory Demographics

  • CLIA Code: 13D2226590
  • Facility Name: IDAHO CHIROPRACTIC GROUP
  • Facility Address: 403 S 11TH ST STE 110
    BOISE, ID
    ZIP 83702
  • Facility Phone: 208 343-6900
  • Facility Type: Other - CHIROPRACTIC
  • Facility Type: Waiver
  • Lab Director: TIMOTHY J. KLENA
  • NPI Number: 1639280712
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 13D2226590
LAB Type Other - CHIROPRACTIC
Facility Name IDAHO CHIROPRACTIC GROUP
Street 403 S 11TH ST STE 110
City BOISE
State ID
ZIP 83702
Phone 208 343-6900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2025
Certificate Expiration Date 6/1/2027
Facility Type Other - CHIROPRACTIC
Lab Director TIMOTHY J. KLENA

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