27D0930376 CLIA NUMBER - EASTER SEALS GOODWILL DBA MEDALLION HOME CARE

Laboratory Demographics

  • CLIA Code: 27D0930376
  • Facility Name: EASTER SEALS GOODWILL DBA MEDALLION HOME CARE
  • Facility Address: 425 1ST AVE N PO BOX 2509
    GREAT FALLS, MT
    ZIP 59401
  • Facility Phone: 406 454-3883
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: NICHOLE STONE
  • NPI Number: 1104953868
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 27D0930376
LAB Type Home Health Agency
Facility Name EASTER SEALS GOODWILL DBA MEDALLION HOME CARE
Street 425 1ST AVE N PO BOX 2509
City GREAT FALLS
State MT
ZIP 59401
Phone 406 454-3883
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2025
Certificate Expiration Date 7/14/2027
Facility Type Home Health Agency
Lab Director NICHOLE STONE

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