27D0673500 CLIA NUMBER - MADISON VALLEY CLINIC

Laboratory Demographics

  • CLIA Code: 27D0673500
  • Facility Name: MADISON VALLEY CLINIC
  • Facility Address: 305 NORTH MAIN STREET
    ENNIS, MT
    ZIP 59729
  • Facility Phone: 406 682-4223
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: DR. DAVENPORT MAURA
  • NPI Number: 1194497883
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 27D0673500
LAB Type Other
Facility Name MADISON VALLEY CLINIC
Street 305 NORTH MAIN STREET
City ENNIS
State MT
ZIP 59729
Phone 406 682-4223
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Other
Lab Director DR. DAVENPORT MAURA

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