Organization · Type 2 NPI

Boise State University

Clinical Medical Laboratory · Boise, ID

NPI number 1770183089 Active

Practice location

2133 W Cesar Chavez Ln Rm 239
Boise, ID 83725-0001

Call (208) 426-1038 Map

Mailing address

1910 University Dr # Ms 1515
Boise, ID 83725-0002

Other practice locations

2100 W University Dr Room 109, Boise, ID 83725-0001 · (208) 426-1523
2100 W University Dr Room 1007, Boise, ID 83725-0001 · (208) 426-2969

Specialties and licenses

Taxonomy	Code	License
Public Health or Welfare Agency	251K00000X	None listed
Clinical Medical Laboratory Primary	291U00000X	None listed

Clinical Medical Laboratory: (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to det…

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NPI record

NPI: 1770183089
Entity type: Organization (Type 2)
Issued: Oct 27, 2020
Last updated: Oct 12, 2023
Status: Active

Other names

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Boise State University Clinical Laboratory · other name
Boise State University Clinical Laboratory · other name

Authorized official

Dr. Stephanie Hudon, PhD
Clinical Lab Manager
(208) 995-3765

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1770183089

Boise State University's National Provider Identifier is 1770183089, issued on Oct 27, 2020. The primary taxonomy on file is Clinical Medical Laboratory (291U00000X), and the practice location is in Boise, ID. The record was last updated on Oct 12, 2023.