CLIA lab
CLIA 13D2100794: Medicine Man Bonners Ferry Pharmacy
Bonners Ferry, ID. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 13D2100794 belongs to Medicine Man Bonners Ferry Pharmacy in Bonners Ferry, ID.
Certificate of Waiver, effective August 21, 2025, expires August 20, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- August 21, 2025
- Certificate expiration
- August 20, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 21, 2015
- Facility type
- Pharmacy
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 13D2100794
- Lab name
- Medicine Man Bonners Ferry Pharmacy
- Address
- 6452 Main Street, Bonners Ferry, ID 83805
- Phone
- (208) 647-4021
- Fax
- (208) 267-4024
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Bonners Ferry, ID
- A Blessed Beginning Pregnancy Resource CenterCertificate of Waiver, Other practitioner13D2125480
- Bonners Ferry Family MedicineCertificate for Provider-Performed Microscopy Procedures, Physician office13D1068553
- Boundary Community ClinicsCertificate of Waiver, Physician office13D0998799
- Boundary Community HospitalCertificate of Compliance, Hospital13D0056658
- Boundary Community Hospital Extended CareCertificate of Waiver, Skilled nursing or nursing facility13D2189262
- Boundary County Community RestoriumCertificate of Waiver, Assisted living facility13D2198697
- Christopher Kolobow NP-C LLCCertificate of Waiver, Other practitioner13D2185601
- Cornerstone Urgent Care & Family MedicineCertificate for Provider-Performed Microscopy Procedures, Independent13D2292263
- Kaniksu Health Services-Bonners FerryCertificate for Provider-Performed Microscopy Procedures, Federally qualified health center13D0998442
- Kootenai Tribal Health ClinicCertificate for Provider-Performed Microscopy Procedures, Community clinic13D0885727
Related
Questions
What is the CLIA number for Medicine Man Bonners Ferry Pharmacy in Bonners Ferry?
13D2100794, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Medicine Man Bonners Ferry Pharmacy hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 13D2100794 expire?
The CMS file lists August 20, 2027 as the certificate expiration date; the certificate took effect August 21, 2025.