STATE OF IDAHO
Organization (NPI-2)
Active
Clinical Medical Laboratory
Provider Information
- NPI Number
1790841781- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 700 EAST ALICE, BLACKFOOT, ID, 83221
- Phone
- (208) 785-8429
- Fax
- (208) 785-8439
Specialties & Taxonomies
Clinical Medical Laboratory
Primary License: ID #13D0520437