13D2305278 CLIA NUMBER - 1ST CHOICE UC & MEDICAL CENTER CHUBBUCK

Laboratory Demographics

  • CLIA Code: 13D2305278
  • Facility Name: 1ST CHOICE UC & MEDICAL CENTER CHUBBUCK
  • Facility Address: 4750 YELLOWSTONE AVE
    POCATELLO, ID
    ZIP 83202
  • Facility Phone: 208 233-1720
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: KYLE CLIFFORD
  • NPI Number: 1295502995
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D2305278
LAB Type Comp. Outpatient Rehab Facility
Facility Name 1ST CHOICE UC & MEDICAL CENTER CHUBBUCK
Street 4750 YELLOWSTONE AVE
City POCATELLO
State ID
ZIP 83202
Phone 208 233-1720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2024
Certificate Expiration Date 5/28/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director KYLE CLIFFORD

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