13D2123963 CLIA NUMBER - NORTHWEST SPECIALTY HOSPITAL

Laboratory Demographics

  • CLIA Code: 13D2123963
  • Facility Name: NORTHWEST SPECIALTY HOSPITAL
  • Facility Address: 1641 E POLSTON AVE STE 101
    POST FALLS, ID
    ZIP 83854
  • Facility Phone: (208) 457-4208
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KELCEY L. TERRELL
  • NPI Number: 1376698027
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 13D2123963
LAB Type Physician Office
Facility Name NORTHWEST SPECIALTY HOSPITAL
Street 1641 E POLSTON AVE STE 101
City POST FALLS
State ID
ZIP 83854
Phone 2084574208
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2025
Certificate Expiration Date 1/5/2027
Facility Type Physician Office
Lab Director KELCEY L. TERRELL

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