NPI age
6 years
Enumerated 2020-02-12
● Active Type 2 · Organization
Subpart
Mini-Cassia Misdemeanor
Mini-Cassia Misdemeanor is 1 of 75 clinical medical laboratory organizations in Idaho.
Primary specialty
Clinical Medical Laboratory
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Prewitt
Director
Last NPPES update
2020-02-12
Source: monthly bulk 2026-05
How this organization compares
Across 75 active clinical medical laboratory providers in Idaho.
NPI age
6 years
↓ 8 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2020 → 2026
2020-02Enumerated in NPPES
2020
2026
Where they practice
Primary practice location
1359 Hansen Ave
Burley, ID 833181821
Mailing address
1359 Hansen Ave
Burley, ID 833181821
Authorized official
Amber Prewitt
Director
📞 2088787361
Specialties
-
Clinical Medical Laboratory Primary(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...
Practice context
Single-site organization. Only one practice location on file.
Subpart of Cassia County.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.