13D2149922 CLIA NUMBER - RITE AID PHARMACY #6200

Laboratory Demographics

  • CLIA Code: 13D2149922
  • Facility Name: RITE AID PHARMACY #6200
  • Facility Address: 43 WEST PRAIRIE SHOPPING CENTER
    HAYDEN, ID
    ZIP 83835
  • Facility Phone: 208 772-2774
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH CASTELLANO
  • NPI Number: 1780793224
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2149922
LAB Type Pharmacy
Facility Name RITE AID PHARMACY #6200
Street 43 WEST PRAIRIE SHOPPING CENTER
City HAYDEN
State ID
ZIP 83835
Phone 208 772-2774
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2024
Certificate Expiration Date 6/12/2026
Facility Type Pharmacy
Lab Director JOSEPH CASTELLANO

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