13D2300695 CLIA NUMBER - TRITON WELLNESS SOLUTIONS & SOFTWAVE THERAPY

Laboratory Demographics

  • CLIA Code: 13D2300695
  • Facility Name: TRITON WELLNESS SOLUTIONS & SOFTWAVE THERAPY
  • Facility Address: 210 W BURNSIDE AVE STE D
    CHUBBUCK, ID
    ZIP 83202
  • Facility Phone: 208 252-5566
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SCOTT B. SCHAFFER
  • NPI Number: 1992408678
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 13D2300695
LAB Type Practitioner Other
Facility Name TRITON WELLNESS SOLUTIONS & SOFTWAVE THERAPY
Street 210 W BURNSIDE AVE STE D
City CHUBBUCK
State ID
ZIP 83202
Phone 208 252-5566
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2024
Certificate Expiration Date 3/13/2026
Facility Type Practitioner Other
Lab Director SCOTT B. SCHAFFER

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