27D0679839 CLIA NUMBER - IVY AT DEER LODGE

Laboratory Demographics

  • CLIA Code: 27D0679839
  • Facility Name: IVY AT DEER LODGE
  • Facility Address: 1100 TEXAS AVE ATTN BUSINESS MANAGER
    DEER LODGE, MT
    ZIP 59722
  • Facility Phone: 406 846-1655
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHRISTINA LARAE ZIMPEL
  • NPI Number: 1356988349
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 27D0679839
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name IVY AT DEER LODGE
Street 1100 TEXAS AVE ATTN BUSINESS MANAGER
City DEER LODGE
State MT
ZIP 59722
Phone 406 846-1655
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 Skilled Nursing Facility/Nursing Facility
Lab Director CHRISTINA LARAE ZIMPEL

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