13D1029187 CLIA NUMBER - CATALYST MEDICAL GROUP-LEWISTON ORTHOPEDICS

Laboratory Demographics

  • CLIA Code: 13D1029187
  • Facility Name: CATALYST MEDICAL GROUP-LEWISTON ORTHOPEDICS
  • Facility Address: 320 WARNER DRIVE
    LEWISTON, ID
    ZIP 83501
  • Facility Phone: 208 746-1383
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KELLY M. BLEWETT
  • NPI Number: 1598871899
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 13D1029187
LAB Type Physician Office
Facility Name CATALYST MEDICAL GROUP-LEWISTON ORTHOPEDICS
Street 320 WARNER DRIVE
City LEWISTON
State ID
ZIP 83501
Phone 208 746-1383
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2024
Certificate Expiration Date 8/9/2026
Facility Type Physician Office
Lab Director KELLY M. BLEWETT

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