13D2328351 CLIA NUMBER - FULL SPECTRUM PSYCHOLOGY

Laboratory Demographics

  • CLIA Code: 13D2328351
  • Facility Name: FULL SPECTRUM PSYCHOLOGY
  • Facility Address: 675 E ANDERSON ST
    IDAHO FALLS, ID
    ZIP 83401
  • Facility Phone: (208) 432-1976
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNA S. RANSBOTTOM
  • NPI Number: 1982418257
  • Taxonomy: 103T00000X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 13D2328351
LAB Type Physician Office
Facility Name FULL SPECTRUM PSYCHOLOGY
Street 675 E ANDERSON ST
City IDAHO FALLS
State ID
ZIP 83401
Phone 2084321976
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2025
Certificate Expiration Date 8/6/2027
Facility Type Physician Office
Lab Director JENNA S. RANSBOTTOM

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This page was last updated on: 6/29/2026