13D1036460 CLIA NUMBER - SAV-ON PHARMACY #0189

Laboratory Demographics

  • CLIA Code: 13D1036460
  • Facility Name: SAV-ON PHARMACY #0189
  • Facility Address: 3614 W STATE ST
    BOISE, ID
    ZIP 83703
  • Facility Phone: 208 426-9639
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIMOTHY FLYNN
  • NPI Number: 1912953423
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D1036460
LAB Type Pharmacy
Facility Name SAV-ON PHARMACY #0189
Street 3614 W STATE ST
City BOISE
State ID
ZIP 83703
Phone 208 426-9639
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Pharmacy
Lab Director TIMOTHY FLYNN

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