27D1031936 CLIA NUMBER - OSCO PHARMACY #0006

Laboratory Demographics

  • CLIA Code: 27D1031936
  • Facility Name: OSCO PHARMACY #0006
  • Facility Address: 200 SOUTH 23RD AVENUE
    BOZEMAN, MT
    ZIP 59718
  • Facility Phone: 406 587-8800
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALICIA D. GOOTKIN
  • NPI Number: 1174579601
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 27D1031936
LAB Type Pharmacy
Facility Name OSCO PHARMACY #0006
Street 200 SOUTH 23RD AVENUE
City BOZEMAN
State MT
ZIP 59718
Phone 406 587-8800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Pharmacy
Lab Director ALICIA D. GOOTKIN

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