27D2130911 CLIA NUMBER - 406 CLINIC PHARMACY

Laboratory Demographics

  • CLIA Code: 27D2130911
  • Facility Name: 406 CLINIC PHARMACY
  • Facility Address: 1315 WYOMING, SUITE B
    MISSOULA, MT
    ZIP 59801
  • Facility Phone: 406 544-8808
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIC R. SHIELDS
  • NPI Number: 1104378439
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 27D2130911
LAB Type Pharmacy
Facility Name 406 CLINIC PHARMACY
Street 1315 WYOMING, SUITE B
City MISSOULA
State MT
ZIP 59801
Phone 406 544-8808
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Pharmacy
Lab Director ERIC R. SHIELDS

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