13D2072959 CLIA NUMBER - LEWIS CLARK KIDNEY & HYPERTENSION CLINIC

Laboratory Demographics

  • CLIA Code: 13D2072959
  • Facility Name: LEWIS CLARK KIDNEY & HYPERTENSION CLINIC
  • Facility Address: 2124 12TH AVE
    LEWISTON, ID
    ZIP 83501
  • Facility Phone: 208 743-9986
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: AJITH J. KUMAR
  • NPI Number: 1437573995
  • Taxonomy: 261QE0700X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 13D2072959
LAB Type Practitioner Other
Facility Name LEWIS CLARK KIDNEY & HYPERTENSION CLINIC
Street 2124 12TH AVE
City LEWISTON
State ID
ZIP 83501
Phone 208 743-9986
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Practitioner Other
Lab Director AJITH J. KUMAR

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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