Organization
IDAHO PATHOLOGY LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS KRAML (CEO)
(208) 785-3801
Entity
Organization
Contact information
Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-4100
(208) 785-8959
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-4100
(208) 785-8959
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
13D0056444
ID
Other
Enumeration date
05/09/2012
Last updated
05/09/2012
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