27D1094510 CLIA NUMBER - GRIZZLY SPINE PAIN & REHAB, PC

Laboratory Demographics

CLIA Number: 27D1094510

Facility Name: GRIZZLY SPINE PAIN & REHAB, PC

Facility Address:
3 MERIDIAN COURT, SUITE 2
KALISPELL, MT
ZIP 59901
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Facility Phone Number: (406) 755-4488

Facility Type: MOBILE LAB

Certificate Type: Waiver

NPI Number: 1104097351

Taxonomy: 261QP3300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	27D1094510
LAB Type	MOBILE LAB
Facility Name	GRIZZLY SPINE PAIN & REHAB, PC
Street	3 MERIDIAN COURT, SUITE 2
City	KALISPELL
State	MT
ZIP	59901
Phone	(406) 755-4488

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This page was last updated on: 5/11/2023