Healthcare Provider Details

I. General information

NPI: 1730052655
Provider Name (Legal Business Name): BLOOD ON THE RUN INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 W CAYUSE CREEK DR STE 100
MERIDIAN ID
83646-4795
US

IV. Provider business mailing address

1516 W CAYUSE CREEK DR STE 100
MERIDIAN ID
83646-4795
US

V. Phone/Fax

Practice location:
  • Phone: 208-747-1600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: TOSHA STRICKLAND
Title or Position: OWNER
Credential:
Phone: 208-760-4400