13D2324873 CLIA NUMBER - WEBER PEDIATRICS PLLC

Laboratory Demographics

  • CLIA Code: 13D2324873
  • Facility Name: WEBER PEDIATRICS PLLC
  • Facility Address: 2216 VINEYARD AVE
    LEWISTON, ID
    ZIP 83501
  • Facility Phone: 208 289-0425
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TYSEN L. WEBER
  • NPI Number: 1477396018
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 13D2324873
LAB Type Physician Office
Facility Name WEBER PEDIATRICS PLLC
Street 2216 VINEYARD AVE
City LEWISTON
State ID
ZIP 83501
Phone 208 289-0425
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2025
Certificate Expiration Date 6/2/2027
Facility Type Physician Office
Lab Director TYSEN L. WEBER

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