NPI age
19 years
Enumerated 2006-12-28
● Active Type 2 · Organization
State Of Idaho
State Of Idaho 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
Heckard
Medical Director
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 75 active clinical medical laboratory providers in Idaho.
NPI age
19 years
↑ 5 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-12Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
700 East Alice
Blackfoot, ID 83221
Mailing address
Box 400, 700 East Alice
Blackfoot, ID 83221
Authorized official
Ralph Duane Heckard, M.D.
Medical Director
📞 2087858429
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Daniel Harrison, PHARM. D. Pharmacist NPI 1013132471
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...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
State Hospital South Laboratory
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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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.