13D2228558 CLIA NUMBER - ISU MERIDIAN HEALTH CARE

Laboratory Demographics

  • CLIA Code: 13D2228558
  • Facility Name: ISU MERIDIAN HEALTH CARE
  • Facility Address: 1311 E CENTRAL DR
    MERIDIAN, ID
    ZIP 83642
  • Facility Phone: 208 373-1734
  • Facility Type: Other - ISU FACILITY CLINIC
  • Facility Type: Microscopy
  • Lab Director: MICHELLE M. ANDERSON
  • NPI Number: 1962095711
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 13D2228558
LAB Type Other - ISU FACILITY CLINIC
Facility Name ISU MERIDIAN HEALTH CARE
Street 1311 E CENTRAL DR
City MERIDIAN
State ID
ZIP 83642
Phone 208 373-1734
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/28/2025
Certificate Expiration Date 6/27/2027
Facility Type Other - ISU FACILITY CLINIC
Lab Director MICHELLE M. ANDERSON

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