27D0690353 CLIA NUMBER - WESTERN MONTANA CLINIC BROADWAY BLDG

Laboratory Demographics

  • CLIA Code: 27D0690353
  • Facility Name: WESTERN MONTANA CLINIC BROADWAY BLDG
  • Facility Address: 500 WEST BROADWAY
    MISSOULA, MT
    ZIP 59802
  • Facility Phone: 406 329-7336
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. ADAM A. VANREGENMORTER
  • NPI Number: 1508033713
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 27D0690353
LAB Type Independent
Facility Name WESTERN MONTANA CLINIC BROADWAY BLDG
Street 500 WEST BROADWAY
City MISSOULA
State MT
ZIP 59802
Phone 406 329-7336
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/2/2024
Certificate Expiration Date 12/1/2026
Facility Type Independent
Lab Director DR. ADAM A. VANREGENMORTER

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