13D2195107 CLIA NUMBER - CORNER DRUG

Laboratory Demographics

  • CLIA Code: 13D2195107
  • Facility Name: CORNER DRUG
  • Facility Address: 10 S MAIN ST
    DRIGGS, ID
    ZIP 83422
  • Facility Phone: 208 354-2334
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SALLY MYLER PHARMD
  • NPI Number: 1942315973
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2195107
LAB Type Pharmacy
Facility Name CORNER DRUG
Street 10 S MAIN ST
City DRIGGS
State ID
ZIP 83422
Phone 208 354-2334
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2024
Certificate Expiration Date 10/5/2026
Facility Type Pharmacy
Lab Director SALLY MYLER PHARMD

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