27D2035466 CLIA NUMBER - FRESENIUS MEDICAL CARE - MISSOULA

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Laboratory Demographics

CLIA Number: 27D2035466

Facility Name: FRESENIUS MEDICAL CARE - MISSOULA

Facility Address:
3100 GREAT NORTHERN AVE
MISSOULA, MT
ZIP 59808
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Facility Phone Number: 406 327-1750

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1861790727

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	27D2035466
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE - MISSOULA
Street	3100 GREAT NORTHERN AVE
City	MISSOULA
State	MT
ZIP	59808
Phone	406 327-1750
CertificateType	4
CertificateEffectiveDate	1/18/2024
CertificateExpirationDate	1/17/2026
FacilityType	Waiver

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