27D2103243 CLIA NUMBER - GLENDIVE AMBULANCE SERVICE

Laboratory Demographics

  • CLIA Code: 27D2103243
  • Facility Name: GLENDIVE AMBULANCE SERVICE
  • Facility Address: 300 SOUTH MERRILL AVE
    GLENDIVE, MT
    ZIP 59330
  • Facility Phone: 406 939-5102
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MARY JO GEHNERT
  • NPI Number: 1982073755
  • Taxonomy: 101YP2500X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 27D2103243
LAB Type Ambulance
Facility Name GLENDIVE AMBULANCE SERVICE
Street 300 SOUTH MERRILL AVE
City GLENDIVE
State MT
ZIP 59330
Phone 406 939-5102
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/8/2025
Certificate Expiration Date 10/7/2027
Facility Type Ambulance
Lab Director MARY JO GEHNERT

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