13D2126011 CLIA NUMBER - RITE AID PHARMACY #5408

Laboratory Demographics

  • CLIA Code: 13D2126011
  • Facility Name: RITE AID PHARMACY #5408
  • Facility Address: 1904 19TH AVENUE
    LEWISTON, ID
    ZIP 83501
  • Facility Phone: 208 743-9127
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH CASTELLANO
  • NPI Number: 1982626891
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2126011
LAB Type Pharmacy
Facility Name RITE AID PHARMACY #5408
Street 1904 19TH AVENUE
City LEWISTON
State ID
ZIP 83501
Phone 208 743-9127
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Pharmacy
Lab Director JOSEPH CASTELLANO

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