13D2203962 CLIA NUMBER - KOHAL PHARMACY INC

Laboratory Demographics

  • CLIA Code: 13D2203962
  • Facility Name: KOHAL PHARMACY INC
  • Facility Address: 740 MCKINLEY AVE BLD B
    KELLOGG, ID
    ZIP 83837
  • Facility Phone: 208 786-9303
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL CONGER PHARMD
  • NPI Number: 1588799902
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2203962
LAB Type Pharmacy
Facility Name KOHAL PHARMACY INC
Street 740 MCKINLEY AVE BLD B
City KELLOGG
State ID
ZIP 83837
Phone 208 786-9303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type Pharmacy
Lab Director MICHAEL CONGER PHARMD

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