27D0706577 CLIA NUMBER - MISSOULA CITY COUNTY HEALTH DEPT

Laboratory Demographics

CLIA Number: 27D0706577

Facility Name: MISSOULA CITY COUNTY HEALTH DEPT

Facility Address:
301 W ALDER STREET
MISSOULA, MT
ZIP 59802
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Facility Phone Number: 406 258-4986

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1528587581

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	27D0706577
LAB Type	Other
Facility Name	MISSOULA CITY COUNTY HEALTH DEPT
Street	301 W ALDER STREET
City	MISSOULA
State	MT
ZIP	59802
Phone	406 258-4986
CertificateType	4
CertificateEffectiveDate	7/28/2023
CertificateExpirationDate	7/27/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024