13D2304479 CLIA NUMBER - KEYSTONE CENTER FOR GERIATRICS

Laboratory Demographics

  • CLIA Code: 13D2304479
  • Facility Name: KEYSTONE CENTER FOR GERIATRICS
  • Facility Address: 305 W BANNOCK ST
    BOISE, ID
    ZIP 83702
  • Facility Phone: 208 963-1034
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MEGAN DUNAY
  • NPI Number: 1770963274
  • Taxonomy: 2081P2900X - Physical Medicine & Rehabilitation

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 13D2304479
LAB Type Physician Office
Facility Name KEYSTONE CENTER FOR GERIATRICS
Street 305 W BANNOCK ST
City BOISE
State ID
ZIP 83702
Phone 208 963-1034
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2024
Certificate Expiration Date 5/13/2026
Facility Type Physician Office
Lab Director MEGAN DUNAY

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