27D2103044 CLIA NUMBER - LAKESIDE QRU

Laboratory Demographics

  • CLIA Code: 27D2103044
  • Facility Name: LAKESIDE QRU
  • Facility Address: 201 BILL'S RD
    LAKESIDE, MT
    ZIP 59922
  • Facility Phone: 406 844-2775
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MARY M. GRANGER
  • NPI Number: 1205875978
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 27D2103044
LAB Type Ambulance
Facility Name LAKESIDE QRU
Street 201 BILL'S RD
City LAKESIDE
State MT
ZIP 59922
Phone 406 844-2775
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2025
Certificate Expiration Date 10/4/2027
Facility Type Ambulance
Lab Director MARY M. GRANGER

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This page was last updated on: 9/29/2025