CLIA lab
CLIA 13D2167279: Broulim's Pharmacy #5
Saint Anthony, ID. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 13D2167279 belongs to Broulim's Pharmacy #5 in Saint Anthony, ID.
Certificate of Waiver, effective June 5, 2025, expires June 4, 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
- June 5, 2025
- Certificate expiration
- June 4, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 5, 2019
- 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
- 13D2167279
- Lab name
- Broulim's Pharmacy #5
- Address
- 301 Aspen Square, Saint Anthony, ID 83445
- Phone
- (208) 624-3158
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 Saint Anthony, ID
- Fremont Medical CenterCertificate of Waiver, Other practitioner13D2269824
- Idaho Department of JuvenileCertificate of Waiver, Prison13D0701052
- Saint Anthony Work CampCertificate of Waiver, Prison13D1005993
- Summit EyecareCertificate of Waiver, Physician office13D2121372
- Upper Valley Community Health ServicesCertificate of Compliance, Federally qualified health center13D1077351
Related
Questions
What is the CLIA number for Broulim's Pharmacy #5 in Saint Anthony?
13D2167279, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Broulim's Pharmacy #5 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 13D2167279 expire?
The CMS file lists June 4, 2027 as the certificate expiration date; the certificate took effect June 5, 2025.