13D2092091 CLIA NUMBER - RITE AID PHARMACY #5414

Laboratory Demographics

  • CLIA Code: 13D2092091
  • Facility Name: RITE AID PHARMACY #5414
  • Facility Address: 7020 W STATE ST
    BOISE, ID
    ZIP 83714
  • Facility Phone: 208 853-3503
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH CASTELLANO
  • NPI Number: 1508975046
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2092091
LAB Type Pharmacy
Facility Name RITE AID PHARMACY #5414
Street 7020 W STATE ST
City BOISE
State ID
ZIP 83714
Phone 208 853-3503
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