27D1090702 CLIA NUMBER - 4 MY KIDS FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 27D1090702

Facility Name: 4 MY KIDS FAMILY PRACTICE

Facility Address:
95 INDIAN TRAIL ROAD
KALISPELL, MT
ZIP 59901
Get Directions

Facility Phone Number: 406 755-6774

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1831341296

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	27D1090702
LAB Type	Community Clinic
Facility Name	4 MY KIDS FAMILY PRACTICE
Street	95 INDIAN TRAIL ROAD
City	KALISPELL
State	MT
ZIP	59901
Phone	406 755-6774
CertificateType	4
CertificateEffectiveDate	10/16/2022
CertificateExpirationDate	10/15/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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