27D0971143 CLIA NUMBER - PROVIDENCE MEDICAL GROUP-FLORENCE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 27D0971143
  • Facility Name: PROVIDENCE MEDICAL GROUP-FLORENCE FAMILY MEDICINE
  • Facility Address: 5549 OLD HIGHWAY 93
    FLORENCE, MT
    ZIP 59833
  • Facility Phone: 406 273-4923
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. LAURA SHELTON
  • NPI Number: 1669791786
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 27D0971143
LAB Type Physician Office
Facility Name PROVIDENCE MEDICAL GROUP-FLORENCE FAMILY MEDICINE
Street 5549 OLD HIGHWAY 93
City FLORENCE
State MT
ZIP 59833
Phone 406 273-4923
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/6/2024
Certificate Expiration Date 3/5/2026
Facility Type Physician Office
Lab Director DR. LAURA SHELTON

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