27D0410875 CLIA NUMBER - MISSOULA OBSTETRICS AND GYNECOLOGY SPECIALISTS

Laboratory Demographics

  • CLIA Code: 27D0410875
  • Facility Name: MISSOULA OBSTETRICS AND GYNECOLOGY SPECIALISTS
  • Facility Address: 2825 FORT MISSOULA ROAD BUILDING 1, SUITE 304
    MISSOULA, MT
    ZIP 59804
  • Facility Phone: 775 741-4594
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DIONNE D. DRAKULICH
  • NPI Number: 1609064013
  • Taxonomy: 2088P0231X - Urology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 27D0410875
LAB Type Physician Office
Facility Name MISSOULA OBSTETRICS AND GYNECOLOGY SPECIALISTS
Street 2825 FORT MISSOULA ROAD BUILDING 1, SUITE 304
City MISSOULA
State MT
ZIP 59804
Phone 775 741-4594
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/5/2025
Certificate Expiration Date 7/4/2027
Facility Type Physician Office
Lab Director DIONNE D. DRAKULICH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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