13D2314821 CLIA NUMBER - JEROME DRUG

Laboratory Demographics

  • CLIA Code: 13D2314821
  • Facility Name: JEROME DRUG
  • Facility Address: 111 PIONEER COURT STE 2
    JEROME, ID
    ZIP 83338
  • Facility Phone: 208 324-2440
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON SMITH
  • NPI Number: 1073800314
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2314821
LAB Type Pharmacy
Facility Name JEROME DRUG
Street 111 PIONEER COURT STE 2
City JEROME
State ID
ZIP 83338
Phone 208 324-2440
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2024
Certificate Expiration Date 11/28/2026
Facility Type Pharmacy
Lab Director BRANDON SMITH

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