13D2295000 CLIA NUMBER - HIGH VALLEY DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 13D2295000
  • Facility Name: HIGH VALLEY DERMATOLOGY
  • Facility Address: 925 S UTAH AVE
    IDAHO FALLS, ID
    ZIP 83402
  • Facility Phone: 208 525-4888
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: BRANDON L. MINER
  • NPI Number: 1891025334
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 13D2295000
LAB Type Physician Office
Facility Name HIGH VALLEY DERMATOLOGY
Street 925 S UTAH AVE
City IDAHO FALLS
State ID
ZIP 83402
Phone 208 525-4888
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Physician Office
Lab Director BRANDON L. MINER

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