CLIA lab
CLIA 13D2165553: Idaho Street Medical Clinic
Homedale, ID. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 13D2165553 belongs to Idaho Street Medical Clinic in Homedale, ID.
Certificate of Waiver, effective April 30, 2025, expires April 29, 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
- April 30, 2025
- Certificate expiration
- April 29, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 30, 2019
- Facility type
- Community clinic
- 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
- 13D2165553
- Lab name
- Idaho Street Medical Clinic
- Address
- 126 West Idaho Ave, Homedale, ID 83628
- Phone
- (208) 859-4103
- Fax
- (208) 337-4652
Annual test volume the lab reported
- Waived tests
- 50
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Homedale, ID
- Owyhee Health & Rehabilitation CenterCertificate of Waiver, Skilled nursing or nursing facility13D0646319
- Sav-On Pharmacy #3366Certificate of Waiver, Pharmacy13D2117206
- Terry Reilly Health - Homedale ClinicCertificate for Provider-Performed Microscopy Procedures, Federally qualified health center13D2102585
Related
Questions
What is the CLIA number for Idaho Street Medical Clinic in Homedale?
13D2165553, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Idaho Street Medical Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 13D2165553 expire?
The CMS file lists April 29, 2027 as the certificate expiration date; the certificate took effect April 30, 2025.