27D1070743 CLIA NUMBER - RAVALLI CO DETENTION FACILITY

Laboratory Demographics

  • CLIA Code: 27D1070743
  • Facility Name: RAVALLI CO DETENTION FACILITY
  • Facility Address: 205 BEDFORD STREET, SUITE I
    HAMILTON, MT
    ZIP 59840
  • Facility Phone: 406 375-4091
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: SUSAN L. DEVINE, RN
  • NPI Number: 1225217581
  • Taxonomy: 251K00000X - Public Health or Welfare

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CLIA Record

Field Name Field Value
CLIA Number 27D1070743
LAB Type Other
Facility Name RAVALLI CO DETENTION FACILITY
Street 205 BEDFORD STREET, SUITE I
City HAMILTON
State MT
ZIP 59840
Phone 406 375-4091
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2025
Certificate Expiration Date 7/8/2027
Facility Type Other
Lab Director SUSAN L. DEVINE, RN

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