13D1095663 CLIA NUMBER - LIBERTY DIALYSIS - SANDPOINT

Laboratory Demographics

  • CLIA Code: 13D1095663
  • Facility Name: LIBERTY DIALYSIS - SANDPOINT
  • Facility Address: 1210 WASHINGTON AVE
    SANDPOINT, ID
    ZIP 83864
  • Facility Phone: 208 263-4488
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SHAUN JOSHI
  • NPI Number: 1285890681
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D1095663
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LIBERTY DIALYSIS - SANDPOINT
Street 1210 WASHINGTON AVE
City SANDPOINT
State ID
ZIP 83864
Phone 208 263-4488
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2025
Certificate Expiration Date 2/12/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SHAUN JOSHI

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