27D2103102 CLIA NUMBER - GOLDEN VALLEY QR AMB SVC

Laboratory Demographics

  • CLIA Code: 27D2103102
  • Facility Name: GOLDEN VALLEY QR AMB SVC
  • Facility Address: 205 RAILWAY AVE
    RYEGATE, MT
    ZIP 59074
  • Facility Phone: 406 568-2100
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: LYLE BURGESS
  • NPI Number: 1679692800
  • Taxonomy: 146N00000X - Emergency Medical Technician, Basic

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CLIA Record

Field Name Field Value
CLIA Number 27D2103102
LAB Type Ambulance
Facility Name GOLDEN VALLEY QR AMB SVC
Street 205 RAILWAY AVE
City RYEGATE
State MT
ZIP 59074
Phone 406 568-2100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2023
Certificate Expiration Date 10/5/2025
Facility Type Ambulance
Lab Director LYLE BURGESS

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This page was last updated on: 6/4/2025