13D2136415 CLIA NUMBER - BROULIMS PHARMACY #6

Laboratory Demographics

  • CLIA Code: 13D2136415
  • Facility Name: BROULIMS PHARMACY #6
  • Facility Address: 124 WEST MAIN ST
    REXBURG, ID
    ZIP 83440
  • Facility Phone: (208) 356-5416
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARCUS C. HURST

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 13D2136415
LAB Type Pharmacy
Facility Name BROULIMS PHARMACY #6
Street 124 WEST MAIN ST
City REXBURG
State ID
ZIP 83440
Phone 2083565416
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2025
Certificate Expiration Date 9/7/2027
Facility Type Pharmacy
Lab Director MARCUS C. HURST

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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