CLIA lab
CLIA 13D2165110: Idaho Physical Medicine and Rehabilitation PA
Mountain Home, ID. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 13D2165110 belongs to Idaho Physical Medicine and Rehabilitation PA in Mountain Home, ID.
Certificate of Waiver, effective April 19, 2025, expires April 18, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- April 19, 2025
- Certificate expiration
- April 18, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 19, 2019
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 13D2165110
- Lab name
- Idaho Physical Medicine and Rehabilitation PA
- Address
- 840 N 4th E, Mountain Home, ID 83647
- Phone
- (208) 884-1333
- Fax
- (208) 489-4015
Annual test volume the lab reported
- Waived tests
- 350
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Mountain Home, ID
- Cottages Senior Living I LLCCertificate of Waiver, Assisted living facility13D2195180
- Doctors Clinic of Elmore CountyCertificate for Provider-Performed Microscopy Procedures, Physician office13D0938420
- Glenns Ferry Health Center IncCertificate for Provider-Performed Microscopy Procedures, Federally qualified health center13D0646318
- Kieffer Chiropractic ClinicCertificate of Waiver, Physician office13D0717775
- Mountain Home CbocCertificate of Accreditation, Community clinic13D2021272
- Mountain Pine DermatologyCertificate for Provider-Performed Microscopy Procedures, Physician office13D2155363
- ST Luke's Clinic - Trinity MountainCertificate for Provider-Performed Microscopy Procedures, Physician office13D0922939
- ST Luke's Clinic Internal MedicineCertificate of Waiver, Community clinic13D2099371
- ST Luke's Elmore Long Term CareCertificate of Waiver, Skilled nursing or nursing facility13D2189985
- ST Luke's Elmore Medical CenterCertificate of Accreditation, Hospital13D0521347
Related
Questions
What is the CLIA number for Idaho Physical Medicine and Rehabilitation PA in Mountain Home?
13D2165110, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Idaho Physical Medicine and Rehabilitation PA hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 13D2165110 expire?
The CMS file lists April 18, 2027 as the certificate expiration date; the certificate took effect April 19, 2025.