Organization
SOUTHERN IDAHO REGIONAL LABORATORY LLC
Active
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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