13D1087337 CLIA NUMBER - IWASA EYE CENTER

Laboratory Demographics

  • CLIA Code: 13D1087337
  • Facility Name: IWASA EYE CENTER
  • Facility Address: 925 NW 12TH ST
    FRUITLAND, ID
    ZIP 83619
  • Facility Phone: 208 452-2151
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL E. IWASA
  • NPI Number: 1346383957
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 13D1087337
LAB Type Physician Office
Facility Name IWASA EYE CENTER
Street 925 NW 12TH ST
City FRUITLAND
State ID
ZIP 83619
Phone 208 452-2151
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2024
Certificate Expiration Date 7/31/2026
Facility Type Physician Office
Lab Director DANIEL E. IWASA

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