NPI age
19 years
Enumerated 2006-06-15
● Active
Type 1 · Individual
Clark R Daines, MD
Daines is 1 of 7 pathology providers in Idaho Falls and 1 of 44 in Idaho.
Primary specialty
Pathology
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2014-06-16
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 44 active pathology providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
State licenses
1 state
13% of peers hold multiple states
Subspecialties
0
36% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-06Enumerated in NPPES
2006
2026
Where they practice
Practice location
3100 Channing Way
Idaho Falls, ID 834047533
Mailing address
1820 E 17th St, Ste 230
Idaho Falls, ID 834046469
Specialties
-
Pathology PrimaryA pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | M11914 | STATE LICENSE |
| 01 (ID) | 79892 | BLUE CROSS IDAHO |
Practice context
Part of a multi-provider practice. 240 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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