13D2132636 CLIA NUMBER - FRUITLAND DIALYSIS

Laboratory Demographics

  • CLIA Code: 13D2132636
  • Facility Name: FRUITLAND DIALYSIS
  • Facility Address: 815 NW 13TH ST
    FRUITLAND, ID
    ZIP 83619
  • Facility Phone: 208 452-3600
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: NICK HUNT
  • NPI Number: 1083146559
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D2132636
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FRUITLAND DIALYSIS
Street 815 NW 13TH ST
City FRUITLAND
State ID
ZIP 83619
Phone 208 452-3600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2025
Certificate Expiration Date 6/25/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director NICK HUNT

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This page was last updated on: 6/4/2025