CLIA lab
CLIA 13D2155363: Mountain Pine Dermatology
Mountain Home, ID. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 13D2155363 belongs to Mountain Pine Dermatology in Mountain Home, ID.
Certificate for Provider-Performed Microscopy Procedures, effective September 27, 2026, expires September 26, 2028.
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 for Provider-Performed Microscopy Procedures
- Certificate effective
- September 27, 2026
- Certificate expiration
- September 26, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 27, 2018
- Facility type
- Physician office
- 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
- 13D2155363
- Lab name
- Mountain Pine Dermatology
- Address
- 110 Rattlesnake St Ste B, Mountain Home, ID 83647
- Phone
- (208) 898-7467
- Fax
- (208) 314-0102
Annual test volume the lab reported
- Waived tests
- 200
- Provider-performed microscopy tests
- 100
- Total
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Idaho Physical Medicine and Rehabilitation PACertificate of Waiver, Physician office13D2165110
- Kieffer Chiropractic ClinicCertificate of Waiver, Physician office13D0717775
- Mountain Home CbocCertificate of Accreditation, Community clinic13D2021272
- ST Luke's Clinic - Trinity MountainCertificate for Provider-Performed Microscopy Procedures, Physician office13D0922939
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- ST Luke's Elmore Long Term CareCertificate of Waiver, Skilled nursing or nursing facility13D2189985
- ST Luke's Elmore Medical CenterCertificate of Accreditation, Hospital13D0521347
Related
Questions
What is the CLIA number for Mountain Pine Dermatology in Mountain Home?
13D2155363, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Mountain Pine Dermatology hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 13D2155363 expire?
The CMS file lists September 26, 2028 as the certificate expiration date; the certificate took effect September 27, 2026.