27D0410104 CLIA NUMBER - GREAT FALLS CLINIC, SPECIALTY CENTER

Laboratory Demographics

  • CLIA Code: 27D0410104
  • Facility Name: GREAT FALLS CLINIC, SPECIALTY CENTER
  • Facility Address: 3000 15TH AVENUE SOUTH
    GREAT FALLS, MT
    ZIP 59405
  • Facility Phone: 406 268-3884
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARK SEAL
  • NPI Number: 1073781548
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 27D0410104
LAB Type Physician Office
Facility Name GREAT FALLS CLINIC, SPECIALTY CENTER
Street 3000 15TH AVENUE SOUTH
City GREAT FALLS
State MT
ZIP 59405
Phone 406 268-3884
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2024
Certificate Expiration Date 1/21/2026
Facility Type Physician Office
Lab Director DR. MARK SEAL

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This page was last updated on: 6/4/2025