27D2007777 CLIA NUMBER - LOGAN HEALTH ENDROCRINOLOGY & INFECTIOUS DISEASE

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Laboratory Demographics

CLIA Number: 27D2007777

Facility Name: LOGAN HEALTH ENDROCRINOLOGY & INFECTIOUS DISEASE

Facility Address:
430 WINDWARD WAY, SUITE 100
KALISPELL, MT
ZIP 59901
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Facility Phone Number: 406 751-5454

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1720678097

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	27D2007777
LAB Type	Physician Office
Facility Name	LOGAN HEALTH ENDROCRINOLOGY & INFECTIOUS DISEASE
Street	430 WINDWARD WAY, SUITE 100
City	KALISPELL
State	MT
ZIP	59901
Phone	406 751-5454
CertificateType	4
CertificateEffectiveDate	5/25/2022
CertificateExpirationDate	5/24/2024
FacilityType	Waiver

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