13D0707947 CLIA NUMBER - NORTH IDAHO UROLOGY - SANDPOINT

Laboratory Demographics

  • CLIA Code: 13D0707947
  • Facility Name: NORTH IDAHO UROLOGY - SANDPOINT
  • Facility Address: 420 N 2ND AVE
    SANDPOINT, ID
    ZIP 83864
  • Facility Phone: 208 263-2335
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RANDIL L. CLARK
  • NPI Number: 1487310702
  • Taxonomy: 106H00000X - Marriage & Family Therapist

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CLIA Record

Field Name Field Value
CLIA Number 13D0707947
LAB Type Physician Office
Facility Name NORTH IDAHO UROLOGY - SANDPOINT
Street 420 N 2ND AVE
City SANDPOINT
State ID
ZIP 83864
Phone 208 263-2335
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 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Physician Office
Lab Director RANDIL L. CLARK

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This page was last updated on: 3/20/2025