13D2237548 CLIA NUMBER - BINGHAM HEALTHCARE SPECIALTY CLINIC & URGENT CARE-YELLOWSTONE

Laboratory Demographics

  • CLIA Code: 13D2237548
  • Facility Name: BINGHAM HEALTHCARE SPECIALTY CLINIC & URGENT CARE-YELLOWSTONE
  • Facility Address: 850 YELLOWSTONE AVE
    POCATELLO, ID
    ZIP 83201
  • Facility Phone: 208 239-8065
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRADY C. MARTIN
  • NPI Number: 1134621436
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 13D2237548
LAB Type Physician Office
Facility Name BINGHAM HEALTHCARE SPECIALTY CLINIC & URGENT CARE-YELLOWSTONE
Street 850 YELLOWSTONE AVE
City POCATELLO
State ID
ZIP 83201
Phone 208 239-8065
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 9/27/2025
Certificate Expiration Date 9/26/2027
Facility Type Physician Office
Lab Director BRADY C. MARTIN

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