13D2036411 CLIA NUMBER - ST JOSEPH RMC CANCER CENTER & BLOOD INSTITUTE

Laboratory Demographics

  • CLIA Code: 13D2036411
  • Facility Name: ST JOSEPH RMC CANCER CENTER & BLOOD INSTITUTE
  • Facility Address: 1250 IDAHO ST
    LEWISTON, ID
    ZIP 83501
  • Facility Phone: 208 743-7427
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GERARDO MIDENCE
  • NPI Number: 1992231799
  • Taxonomy: 332BX2000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 13D2036411
LAB Type Physician Office
Facility Name ST JOSEPH RMC CANCER CENTER & BLOOD INSTITUTE
Street 1250 IDAHO ST
City LEWISTON
State ID
ZIP 83501
Phone 208 743-7427
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2024
Certificate Expiration Date 2/6/2026
Facility Type Physician Office
Lab Director GERARDO MIDENCE

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