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Contact Information

EASTERN IDAHO LABORATORY CONSULTANTS LLC
3100 CHANNING WAY
IDAHO FALLS, ID83404-7533
 Phone: 208-259-6111
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for EASTERN IDAHO LABORATORY CONSULTANTS LLC

NPI # 1043060536
LBN Legal business name EASTERN IDAHO LABORATORY CONSULTANTS LLC
Authorized official CLARK DAINES - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/26/2024
Last updated 03/28/2024 - About 2 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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