13D2092088 CLIA NUMBER - RITE AID PHARMACY #5413

Laboratory Demographics

  • CLIA Code: 13D2092088
  • Facility Name: RITE AID PHARMACY #5413
  • Facility Address: 1515 W STATE ST
    BOISE, ID
    ZIP 83702
  • Facility Phone: 208 345-7684
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH CASTELLANO
  • NPI Number: 1164438461
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2092088
LAB Type Pharmacy
Facility Name RITE AID PHARMACY #5413
Street 1515 W STATE ST
City BOISE
State ID
ZIP 83702
Phone 208 345-7684
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2025
Certificate Expiration Date 2/25/2027
Facility Type Pharmacy
Lab Director JOSEPH CASTELLANO

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