Idaho Pathology Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

13D0056444 Issued in ID

Legal business name

IDAHO PATHOLOGY LABORATORY

Practice address

98 Poplar St
Blackfoot, ID 83221-1758

Phone

(208) 785-4100

Fax

(208) 785-8959

NPI assigned

May 9, 2012

Last updated

May 9, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Louis Kraml

Title

Ceo

Phone

(208) 785-3801

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1205195484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-785-4100",
            "fax_number": "208-785-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-785-4100",
            "fax_number": "208-785-8959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO PATHOLOGY LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-09",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "KRAML",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-785-3801"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "ID",
            "license": "13D0056444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idaho Dept of Health & Welfare Reg 6 CMH BF C
• Idaho Dept of Health & Welfare Reg 7 Amh BF
• Idaho Dept of Health & Welfare Reg 7 CMH P C
• Idaho Express Transportation LLC
• Idaho Kidney Center-Blackfoot LLC (Idaho Kidney Center-Blackfoot)
• Idaho Physicians Clinic
• Idaho Science & Technology Charter School
• Harrison Jacob Inskeep
• Intercept Systems, PLLC
• J&M Mental Health, Inc.

• Clinical Medical Laboratory in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Clinical Medical Laboratory in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; 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.