13D2167774 CLIA NUMBER - RATHDRUM CLINIC INC DBA RESTORED HORIZONS

Laboratory Demographics

  • CLIA Code: 13D2167774
  • Facility Name: RATHDRUM CLINIC INC DBA RESTORED HORIZONS
  • Facility Address: 14775 N KIMO CT STE B&C
    RATHDRUM, ID
    ZIP 83858
  • Facility Phone: 208 819-7103
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL D. WHITING
  • NPI Number: 1538503693
  • Taxonomy: 207QA0401X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 13D2167774
LAB Type Physician Office
Facility Name RATHDRUM CLINIC INC DBA RESTORED HORIZONS
Street 14775 N KIMO CT STE B&C
City RATHDRUM
State ID
ZIP 83858
Phone 208 819-7103
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Physician Office
Lab Director MICHAEL D. WHITING

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: 9/29/2025