13D0949934 CLIA NUMBER - COEUR D'ALENE PEDIATRICS OF POST FALLS

Laboratory Demographics

  • CLIA Code: 13D0949934
  • Facility Name: COEUR D'ALENE PEDIATRICS OF POST FALLS
  • Facility Address: 1300 E MULLAN AVE STE 1000
    POST FALLS, ID
    ZIP 83854
  • Facility Phone: 208 777-1330
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DUANE E. CRADDOCK
  • NPI Number: 1093796468
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 13D0949934
LAB Type Physician Office
Facility Name COEUR D'ALENE PEDIATRICS OF POST FALLS
Street 1300 E MULLAN AVE STE 1000
City POST FALLS
State ID
ZIP 83854
Phone 208 777-1330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2025
Certificate Expiration Date 6/30/2027
Facility Type Physician Office
Lab Director DUANE E. CRADDOCK

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