13D2203970 CLIA NUMBER - KOHAL PHARMACY INC

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CLIA Record

Field Name Field Value
CLIA Number 13D2203970
LAB Type Pharmacy
Facility Name KOHAL PHARMACY INC
Street 504 N DIVISION ST
City PINEHURST
State ID
ZIP 83850
Phone 208 682-4015
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