27D2158765 CLIA NUMBER - BIG SKY FAMILY HEALTH CLINIC

Laboratory Demographics

CLIA Number: 27D2158765

Facility Name: BIG SKY FAMILY HEALTH CLINIC

Facility Address:
2210 HARRISON AVE
BUTTE, MT
ZIP 59701
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Facility Phone Number: 406 491-1259

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1831802289

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	27D2158765
LAB Type	Practitioner Other
Facility Name	BIG SKY FAMILY HEALTH CLINIC
Street	2210 HARRISON AVE
City	BUTTE
State	MT
ZIP	59701
Phone	406 491-1259
CertificateType	4
CertificateEffectiveDate	12/6/2022
CertificateExpirationDate	12/5/2024
FacilityType	Waiver

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