13D2296652 CLIA NUMBER - ALLEN DRUG INC

Laboratory Demographics

  • CLIA Code: 13D2296652
  • Facility Name: ALLEN DRUG INC
  • Facility Address: 4 NORTH MAIN
    MALAD CITY, ID
    ZIP 83252
  • Facility Phone: 208 766-2241
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: RICHARD V. ALLEN
  • NPI Number: 1922164292
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2296652
LAB Type Prison
Facility Name ALLEN DRUG INC
Street 4 NORTH MAIN
City MALAD CITY
State ID
ZIP 83252
Phone 208 766-2241
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Prison
Lab Director RICHARD V. ALLEN

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