13D0895833 CLIA NUMBER - ADA WEST DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 13D0895833
  • Facility Name: ADA WEST DERMATOLOGY
  • Facility Address: 1618 S MILLENNIUM WAY STE #200
    MERIDIAN, ID
    ZIP 83642
  • Facility Phone: 208 884-3376
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DANIEL WINCHESTER
  • NPI Number: 1518973338
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 13D0895833
LAB Type Physician Office
Facility Name ADA WEST DERMATOLOGY
Street 1618 S MILLENNIUM WAY STE #200
City MERIDIAN
State ID
ZIP 83642
Phone 208 884-3376
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Physician Office
Lab Director DANIEL WINCHESTER

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This page was last updated on: 9/29/2025