13D2192332 CLIA NUMBER - SNAKE RIVER COMMUNITY CLINIC

Laboratory Demographics

  • CLIA Code: 13D2192332
  • Facility Name: SNAKE RIVER COMMUNITY CLINIC
  • Facility Address: 215 10TH ST
    LEWISTON, ID
    ZIP 83501
  • Facility Phone: 208 743-5899
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: HEATHER M. BEASLEY
  • NPI Number: 1003440082
  • Taxonomy: 163WG0000X - Registered Nurse

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CLIA Record

Field Name Field Value
CLIA Number 13D2192332
LAB Type Community Clinic
Facility Name SNAKE RIVER COMMUNITY CLINIC
Street 215 10TH ST
City LEWISTON
State ID
ZIP 83501
Phone 208 743-5899
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type Community Clinic
Lab Director HEATHER M. BEASLEY

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