27D1066198 CLIA NUMBER - LOGAN HEALTH WELLNESS & PAIN MANAGEMENT

Laboratory Demographics

CLIA Number: 27D1066198

Facility Name: LOGAN HEALTH WELLNESS & PAIN MANAGEMENT

Facility Address:
245 WINDWARD WAY, #100
KALISPELL, MT
ZIP 59901
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Facility Phone Number: 406 756-8488

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1972197499

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	27D1066198
LAB Type	Physician Office
Facility Name	LOGAN HEALTH WELLNESS & PAIN MANAGEMENT
Street	245 WINDWARD WAY, #100
City	KALISPELL
State	MT
ZIP	59901
Phone	406 756-8488
CertificateType	3
CertificateEffectiveDate	1/2/2023
CertificateExpirationDate	1/1/2025
FacilityType	PPMP

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