13D2233937 CLIA NUMBER - CLINICAL RESEARCH PRIME REXBURG

Laboratory Demographics

  • CLIA Code: 13D2233937
  • Facility Name: CLINICAL RESEARCH PRIME REXBURG
  • Facility Address: 420 EAST 4TH NORTH
    REXBURG, ID
    ZIP 83440
  • Facility Phone: 208 497-0600
  • Facility Type: Other - CLINICAL RESEARCH FACILIT
  • Facility Type: Waiver
  • Lab Director: JEFFREY B. BAKER
  • NPI Number: 1124560230
  • Taxonomy: 261QR1100X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 13D2233937
LAB Type Other - CLINICAL RESEARCH FACILIT
Facility Name CLINICAL RESEARCH PRIME REXBURG
Street 420 EAST 4TH NORTH
City REXBURG
State ID
ZIP 83440
Phone 208 497-0600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2025
Certificate Expiration Date 8/25/2027
Facility Type Other - CLINICAL RESEARCH FACILIT
Lab Director JEFFREY B. BAKER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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