Organization
SOUTHERN IDAHO REGIONAL LABORATORY LLC
Active
Other names
Treasure Valley Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KURT ROGERS (CFO)
(509) 755-8903
Entity
Organization
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(800) 574-8854
Mailing address
BOX 2693, SPOKANE, WA 99220
(800) 574-8854
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805437200
—
ID
Enumeration date
12/20/2005
Last updated
01/06/2010
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