13D2067990 CLIA NUMBER - ALAMEDA VISION CENTER

Laboratory Demographics

  • CLIA Code: 13D2067990
  • Facility Name: ALAMEDA VISION CENTER
  • Facility Address: 1155 POCATELLO CREEK RD
    POCATELLO, ID
    ZIP 83201
  • Facility Phone: 208 233-2020
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: COLEMAN S. ANDERSON
  • NPI Number: 1114901535
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 13D2067990
LAB Type Physician Office
Facility Name ALAMEDA VISION CENTER
Street 1155 POCATELLO CREEK RD
City POCATELLO
State ID
ZIP 83201
Phone 208 233-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2023
Certificate Expiration Date 10/24/2025
Facility Type Physician Office
Lab Director COLEMAN S. ANDERSON

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