13D2283356 CLIA NUMBER - SELKIRK ENDOCRINOLOGY

Laboratory Demographics

  • CLIA Code: 13D2283356
  • Facility Name: SELKIRK ENDOCRINOLOGY
  • Facility Address: 30544 HIGHWAY 200 STE 303
    PONDERAY, ID
    ZIP 83852
  • Facility Phone: 208 758-0075
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: ADAM A. LYKO
  • NPI Number: 1285142943
  • Taxonomy: 207RE0101X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D2283356
LAB Type Independent
Facility Name SELKIRK ENDOCRINOLOGY
Street 30544 HIGHWAY 200 STE 303
City PONDERAY
State ID
ZIP 83852
Phone 208 758-0075
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2025
Certificate Expiration Date 6/5/2027
Facility Type Independent
Lab Director ADAM A. LYKO

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