CLINICAL RESEARCH PRIME NPI 1124560230

NPI Information

  • NPI: 1124560230
  • Provider Name: CLINICAL RESEARCH PRIME
  • Classification: Clinic/Center - 261QR1100X
  • Specialization: Research
  • Entity Type: Organization
  • CLIA Number: 13D2233937
  • Address: 187 E 13TH ST
    IDAHO FALLS, ID
    ZIP 83404
  • Phone: (208) 497-0600

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NPI Details

CLINICAL RESEARCH PRIME is a research clinic center in Idaho Falls, ID. CLINICAL RESEARCH PRIME NPI is 1124560230. The provider is registered as an organization entity type.

The provider's business location address is:

187 E 13TH ST
IDAHO FALLS, ID
ZIP 83404-305
Phone: (208) 497-0600

The provider's authorized official is Justin Baker .
The authorized official title is President, Chief Research Officer and has the following contact phone number (208) 497-0600.

The CLIA number assigned to this NPI record is 13D2233937 - other - clinical research facilit with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/7/2016 and was last updated on 11/7/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR1100XClinic/CenterResearchM5835IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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