27D2102714 CLIA NUMBER - PARK CITY AMBULANCE SERVICE

Laboratory Demographics

  • CLIA Code: 27D2102714
  • Facility Name: PARK CITY AMBULANCE SERVICE
  • Facility Address: 110 2ND STREET SW
    PARK CITY, MT
    ZIP 59063
  • Facility Phone: 406 633-2015
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: DOROTHY S. ALEGRIA
  • NPI Number: 1730147430
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 27D2102714
LAB Type Ambulance
Facility Name PARK CITY AMBULANCE SERVICE
Street 110 2ND STREET SW
City PARK CITY
State MT
ZIP 59063
Phone 406 633-2015
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2023
Certificate Expiration Date 9/27/2025
Facility Type Ambulance
Lab Director DOROTHY S. ALEGRIA

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This page was last updated on: 3/20/2025