13D1058147 CLIA NUMBER - SHAVER PHARMACY & COMPOUNDING CENTER

Laboratory Demographics

  • CLIA Code: 13D1058147
  • Facility Name: SHAVER PHARMACY & COMPOUNDING CENTER
  • Facility Address: 235 S 4TH AVE
    POCATELLO, ID
    ZIP 83201
  • Facility Phone: (208) 233-3341
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LORRI D. GEBO-SHAVER
  • NPI Number: 1083720494
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D1058147
LAB Type Physician Office
Facility Name SHAVER PHARMACY & COMPOUNDING CENTER
Street 235 S 4TH AVE
City POCATELLO
State ID
ZIP 83201
Phone 2082333341
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2024
Certificate Expiration Date 8/29/2026
Facility Type Physician Office
Lab Director LORRI D. GEBO-SHAVER

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This page was last updated on: 5/18/2026