13D1021859 CLIA NUMBER - PALOUSE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 13D1021859
  • Facility Name: PALOUSE SURGERY CENTER
  • Facility Address: 2300 WEST A ST
    MOSCOW, ID
    ZIP 83843
  • Facility Phone: 208 883-1500
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: AMY CLARK
  • NPI Number: 1750386256
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D1021859
LAB Type Ambulatory Surgery Center
Facility Name PALOUSE SURGERY CENTER
Street 2300 WEST A ST
City MOSCOW
State ID
ZIP 83843
Phone 208 883-1500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type Ambulatory Surgery Center
Lab Director AMY CLARK

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