27D2158703 CLIA NUMBER - ALLERGY & ASTHMA CENTER PC

Laboratory Demographics

CLIA Number: 27D2158703

Facility Name: ALLERGY & ASTHMA CENTER PC

Facility Address:
95 INDIAN TRAIL RD
KALISPELL, MT
ZIP 59901
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Facility Phone Number: 406 300-4882

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1750453163

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	27D2158703
LAB Type	Physician Office
Facility Name	ALLERGY & ASTHMA CENTER PC
Street	95 INDIAN TRAIL RD
City	KALISPELL
State	MT
ZIP	59901
Phone	406 300-4882
CertificateType	4
CertificateEffectiveDate	12/4/2022
CertificateExpirationDate	12/3/2024
FacilityType	Waiver

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