13D0933598 CLIA NUMBER - MOUNTAIN VALLEY OF CASCADIA

Laboratory Demographics

  • CLIA Code: 13D0933598
  • Facility Name: MOUNTAIN VALLEY OF CASCADIA
  • Facility Address: 601 W CAMERON AVE
    KELLOGG, ID
    ZIP 83837
  • Facility Phone: 208 784-1283
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: EMILEE KULIN
  • NPI Number: 1396261202
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 13D0933598
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MOUNTAIN VALLEY OF CASCADIA
Street 601 W CAMERON AVE
City KELLOGG
State ID
ZIP 83837
Phone 208 784-1283
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2025
Certificate Expiration Date 9/15/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director EMILEE KULIN

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