27D2141719 CLIA NUMBER - BOZEMAN HEALTH CONVENIENCE CARE, LLC

Laboratory Demographics

CLIA Number: 27D2141719

Facility Name: BOZEMAN HEALTH CONVENIENCE CARE, LLC

Facility Address:
1805 WEST OAK STREET, SUITE 3
BOZEMAN, MT
ZIP 59715
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Facility Phone Number: 406 414-4890

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1750890232

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	27D2141719
LAB Type	Community Clinic
Facility Name	BOZEMAN HEALTH CONVENIENCE CARE, LLC
Street	1805 WEST OAK STREET, SUITE 3
City	BOZEMAN
State	MT
ZIP	59715
Phone	406 414-4890
CertificateType	4
CertificateEffectiveDate	12/19/2023
CertificateExpirationDate	12/18/2025
FacilityType	Waiver

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