27D0938483 CLIA NUMBER - BIG SKY SURGERY CENTER

Laboratory Demographics

CLIA Number: 27D0938483

Facility Name: BIG SKY SURGERY CENTER

Facility Address:
2833 FORT MISSOULA ROAD
MISSOULA, MT
ZIP 59804
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Facility Phone Number: 406 542-6559

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1639158645

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	27D0938483
LAB Type	Ambulatory Surgery Center
Facility Name	BIG SKY SURGERY CENTER
Street	2833 FORT MISSOULA ROAD
City	MISSOULA
State	MT
ZIP	59804
Phone	406 542-6559
CertificateType	4
CertificateEffectiveDate	1/8/2024
CertificateExpirationDate	1/7/2026
FacilityType	Waiver

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