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TRI-STATE MEMORIAL HOSPITAL
NPI 1386690907
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Lewiston, ID

Active since May 25, 2006CLIA 50D2209781 · Waiver
730 21ST ST, LEWISTON, ID 83501(208) 746-8280(208) 746-8285 Get Directions Write a Review

NPPES record last updated: August 4, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Tri-state Memorial Hospital NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRI-STATE MEMORIAL HOSPITAL (NPI 1386690907), doing business as Tri State Dialysis Center, is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Lewiston, Idaho and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Alex C. Town, Cfo, as its authorized official.

NPPES Registry Identity

NPI1386690907
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameTRI-STATE MEMORIAL HOSPITAL
Location Address730 21ST STLewiston, ID 83501-3323
Mailing Address1221 Highland Ave., Po Box 189Clarkston, WA 98940 · (509) 758-5511 · Fax (509) 751-9406
Phone(208) 746-8280
Fax(208) 746-8285
Organization SubpartNo
Authorized OfficialAlex C. TownCfo · (509) 758-4667
Enumeration DateMay 25, 2006
Last NPPES UpdateAugust 4, 2009
✔ NPI 1386690907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
License✔ Licensed in WA · H-108
730 21ST ST, Lewiston, ID 83501
Open in Google Maps ↗

Other Names 1

Former Legal Business NameTri State Dialysis Center

Other Identifiers 4

Medicare OSCAR/certification502310WA
Medicare OSCAR/certification132509
Medicaid003110900ID
Medicaid3308004WA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2209781

Tri-State Dialysis Center · Clarkston, WA
Active · expires Apr 4, 2028
CLIA Number50D2209781
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateJanuary 15, 2021
Certificate Expiration DateApril 4, 2028
Laboratory DirectorMeheretab Feleke
Laboratory Phone(509) 758-4656
Laboratory LocationTri-State Dialysis Center1221 Highland Ave, Clarkston, WA 99403
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tri-State Memorial Hospital's NPI number?

The NPI number for Tri-State Memorial Hospital is 1386690907. It was assigned to this organization in the NPPES registry on May 25, 2006. The provider was formerly known as Tri State Dialysis Center.

Where is Tri-State Memorial Hospital located?

Tri-State Memorial Hospital is located at 730 21st St, Lewiston, ID 83501. The listed phone number is (208) 746-8280.

What is Tri-State Memorial Hospital's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does Tri-State Memorial Hospital hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2209781) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Tri-State Memorial Hospital was last updated on August 4, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.