13D2092101 CLIA NUMBER - LEWIS-CLARK KIDNEY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 13D2092101
  • Facility Name: LEWIS-CLARK KIDNEY CENTER, LLC
  • Facility Address: 2116 12TH AVE
    LEWISTON, ID
    ZIP 83501
  • Facility Phone: (208) 743-0662
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: AJITH J. KUMAR
  • NPI Number: 1457749475
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D2092101
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LEWIS-CLARK KIDNEY CENTER, LLC
Street 2116 12TH AVE
City LEWISTON
State ID
ZIP 83501
Phone 2087430662
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 End Stage Renal Disease Dialysis Facility
Lab Director AJITH J. KUMAR

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This page was last updated on: 5/18/2026