13D2092096 CLIA NUMBER - RITE AID PHARMACY #5409

Laboratory Demographics

  • CLIA Code: 13D2092096
  • Facility Name: RITE AID PHARMACY #5409
  • Facility Address: 2107 BLAINE STREET
    CALDWELL, ID
    ZIP 83605
  • Facility Phone: 208 455-1094
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH CASTELLANO
  • NPI Number: 1962511402
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2092096
LAB Type Pharmacy
Facility Name RITE AID PHARMACY #5409
Street 2107 BLAINE STREET
City CALDWELL
State ID
ZIP 83605
Phone 208 455-1094
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