13D0674117 CLIA NUMBER - ST LUKE'S CLINIC - UROLOGY CALDWELL

Laboratory Demographics

  • CLIA Code: 13D0674117
  • Facility Name: ST LUKE'S CLINIC - UROLOGY CALDWELL
  • Facility Address: 1906 FAIRVIEW AVE STE 350
    CALDWELL, ID
    ZIP 83605
  • Facility Phone: (208) 454-9181
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: GREGORY T. ADAMS
  • NPI Number: 1952604563
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 13D0674117
LAB Type Community Clinic
Facility Name ST LUKE'S CLINIC - UROLOGY CALDWELL
Street 1906 FAIRVIEW AVE STE 350
City CALDWELL
State ID
ZIP 83605
Phone 2084549181
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Community Clinic
Lab Director GREGORY T. ADAMS

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This page was last updated on: 5/18/2026