13D2255657 CLIA NUMBER - IDAHO OTOLOGIC SURGERY CENTER DBA SYRINGA OUTPATIENT SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 13D2255657
  • Facility Name: IDAHO OTOLOGIC SURGERY CENTER DBA SYRINGA OUTPATIENT SURGERY CENTER
  • Facility Address: 1209 N SUMMER BROOK AVE #100
    MERIDIAN, ID
    ZIP 83642
  • Facility Phone: 208 938-5823
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JAMES V. CRAWFORD
  • NPI Number: 1972179208
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D2255657
LAB Type Ambulatory Surgery Center
Facility Name IDAHO OTOLOGIC SURGERY CENTER DBA SYRINGA OUTPATIENT SURGERY CENTER
Street 1209 N SUMMER BROOK AVE #100
City MERIDIAN
State ID
ZIP 83642
Phone 208 938-5823
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2024
Certificate Expiration Date 3/15/2026
Facility Type Ambulatory Surgery Center
Lab Director JAMES V. CRAWFORD

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