13D2310441 CLIA NUMBER - UROLOGY CLINIC, THE

Laboratory Demographics

  • CLIA Code: 13D2310441
  • Facility Name: UROLOGY CLINIC, THE
  • Facility Address: 875 S VANGUARD WAY STE 200D
    MERIDIAN, ID
    ZIP 83642
  • Facility Phone: 208 782-6730
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MICHAEL B. TAYLOR
  • NPI Number: 1659113975
  • Taxonomy: 208800000X - Urology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 13D2310441
LAB Type Physician Office
Facility Name UROLOGY CLINIC, THE
Street 875 S VANGUARD WAY STE 200D
City MERIDIAN
State ID
ZIP 83642
Phone 208 782-6730
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/4/2024
Certificate Expiration Date 9/3/2026
Facility Type Physician Office
Lab Director MICHAEL B. TAYLOR

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