13D2299629 CLIA NUMBER - ONEPEAK MEDICAL CARE

Laboratory Demographics

  • CLIA Code: 13D2299629
  • Facility Name: ONEPEAK MEDICAL CARE
  • Facility Address: 1003 NORTH ORCHARD ST
    BOISE, ID
    ZIP 83706
  • Facility Phone: 208 331-6700
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SUSAN N. SANSOM
  • NPI Number: 1811750458
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 13D2299629
LAB Type Practitioner Other
Facility Name ONEPEAK MEDICAL CARE
Street 1003 NORTH ORCHARD ST
City BOISE
State ID
ZIP 83706
Phone 208 331-6700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Practitioner Other
Lab Director SUSAN N. SANSOM

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