13D2299912 CLIA NUMBER - WALTER M GRAHAM MD

Laboratory Demographics

  • CLIA Code: 13D2299912
  • Facility Name: WALTER M GRAHAM MD
  • Facility Address: 32 S 150 E
    BURLEY, ID
    ZIP 83318
  • Facility Phone: 208 677-3034
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WALTER M. GRAHAM
  • NPI Number: 1821031758
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 13D2299912
LAB Type Physician Office
Facility Name WALTER M GRAHAM MD
Street 32 S 150 E
City BURLEY
State ID
ZIP 83318
Phone 208 677-3034
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2024
Certificate Expiration Date 2/27/2026
Facility Type Physician Office
Lab Director WALTER M. GRAHAM

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