NPI 1295105567

Idaho State University

Organisation Clinical Medical Laboratory Pocatello, ID

Practice location

Address: 970 S 5th Ave Stop 8288, Pocatello, ID 83209-0001
Phone: (208) 282-4456
Mailing address: 921 S 8th Ave Stop 8288, Pocatello, ID 83209-0001

Authorised official

Name: James A. Fletcher
Title: Vice President of Finance & Admin.
Phone: (208) 282-3540

Registered specialties

Clinical Medical Laboratory Primary

Laboratories Taxonomy 291U00000X

Other Clinical Medical Laboratory providers in Idaho →

Registry record

NPI: 1295105567
Entity type: Organization
NPI issued: 30 Sep 2015
Record last updated: 30 Sep 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.