13D2188141 CLIA NUMBER - CUSTOMEDICA PHARMACY NORTH END

Laboratory Demographics

  • CLIA Code: 13D2188141
  • Facility Name: CUSTOMEDICA PHARMACY NORTH END
  • Facility Address: 1915 W STATE ST
    BOISE, ID
    ZIP 83702
  • Facility Phone: (208) 515-2211
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW C. MURRAY PHARMD
  • NPI Number: 1982159133
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2188141
LAB Type Pharmacy
Facility Name CUSTOMEDICA PHARMACY NORTH END
Street 1915 W STATE ST
City BOISE
State ID
ZIP 83702
Phone 2085152211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2024
Certificate Expiration Date 7/12/2026
Facility Type Pharmacy
Lab Director MATTHEW C. MURRAY PHARMD

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