13D2321268 CLIA NUMBER - FRONT LINE EMS

Laboratory Demographics

  • CLIA Code: 13D2321268
  • Facility Name: FRONT LINE EMS
  • Facility Address: 2925 S COLE RD STE #120
    BOISE, ID
    ZIP 83709
  • Facility Phone: 208 580-4296
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: CLIFFORD W. STOUTENBURG
  • NPI Number: 1255802047
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 13D2321268
LAB Type Ambulance
Facility Name FRONT LINE EMS
Street 2925 S COLE RD STE #120
City BOISE
State ID
ZIP 83709
Phone 208 580-4296
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Ambulance
Lab Director CLIFFORD W. STOUTENBURG

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