13D2267844 CLIA NUMBER - ALBERTSONS PHARMACY #3065

Laboratory Demographics

  • CLIA Code: 13D2267844
  • Facility Name: ALBERTSONS PHARMACY #3065
  • Facility Address: 4657 S EAGLE RD
    MERIDIAN, ID
    ZIP 83642
  • Facility Phone: 208 272-9730
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIMOTHY FLYNN
  • NPI Number: 1164460309
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2267844
LAB Type Pharmacy
Facility Name ALBERTSONS PHARMACY #3065
Street 4657 S EAGLE RD
City MERIDIAN
State ID
ZIP 83642
Phone 208 272-9730
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Pharmacy
Lab Director TIMOTHY FLYNN

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