NPIMap

Organization Active NPI

St Lukes Regional Medical Center

Doing business as St Lukes Reference Laboratory

  • Clinical Medical Laboratory
  • Boise, ID
National Provider Identifier
1093109100
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
6919 Issued in ID
Legal business name
ST LUKES REGIONAL MEDICAL CENTER
Doing business as
St Lukes Reference Laboratory
Practice address
3176 S Denver Way
Boise, ID 83705-5289
Phone
(208) 706-5000
NPI assigned
Mar 26, 2015
Last updated
Mar 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeff Taylor
Title
Treasurer/Cfo
Phone
(208) 381-2520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 6919 ID Primary

Addresses

Primary practice location

3176 S Denver Way
Boise, ID 83705-5289

Mailing address

PO Box 2777
Boise, ID 83701-2777

Other names 1

  • ST LUKES REFERENCE LABORATORY Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2018947St Luke's Regional Medical Center's3176 S Denver Way, Boise, ID 83705AccreditationMar 27, 2028

National Provider Directory

National Provider Directory
Tax ID family
Ted Thurman FNP50 organizations share this tax ID, including this one

Other organizations with this tax ID 49

Organizations that report the same tax identification number in the National Provider Directory.

View all 49

Locations

3176 S Denver Way
Boise, ID 83705
Phone (208) 381-8829

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1093109100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2777",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837012777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3176 S DENVER WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837055289",
            "telephone_number": "208-706-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-26",
        "last_updated": "2015-03-26",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "TREASURER/CFO",
        "authorized_official_telephone_number": "208-381-2520"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "ID",
            "license": "6919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST LUKES REFERENCE LABORATORY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.