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27D2107905 CLIA NUMBER - WESTERN MONTANA CLINIC PATHOLOGY

Laboratory Demographics

CLIA Number: 27D2107905

Facility Name: WESTERN MONTANA CLINIC PATHOLOGY

Facility Address:
500 WEST BROADWAY
MISSOULA, MT
ZIP 59802
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Facility Phone Number: 406 329-7336

Facility Type: Independent

Certificate Type: Certificate of Compliance
NPI Number: 1942253182

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 27D2107905
LAB Type Independent
Facility Name WESTERN MONTANA CLINIC PATHOLOGY
Street 500 WEST BROADWAY
City MISSOULA
State MT
ZIP 59802
Phone 406 329-7336
CertificateType 2
CertificateEffectiveDate 5/18/2022
CertificateExpirationDate 5/17/2024
FacilityType Compliance

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