24D2301869 CLIA NUMBER - CHRIS BOSEOVSKI MD LTD

Laboratory Demographics

  • CLIA Code: 24D2301869
  • Facility Name: CHRIS BOSEOVSKI MD LTD
  • Facility Address: 100 OAK AVE SW
    MONTGOMERY, MN
    ZIP 56069
  • Facility Phone: 707 494-2802
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRIS BOSEOVSKI
  • NPI Number: 1508940107
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 24D2301869
LAB Type Physician Office
Facility Name CHRIS BOSEOVSKI MD LTD
Street 100 OAK AVE SW
City MONTGOMERY
State MN
ZIP 56069
Phone 707 494-2802
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2024
Certificate Expiration Date 4/1/2026
Facility Type Physician Office
Lab Director CHRIS BOSEOVSKI

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This page was last updated on: 9/29/2025