27D2159316 CLIA NUMBER - BOZEMAN PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 27D2159316
  • Facility Name: BOZEMAN PRIMARY CARE
  • Facility Address: 4535 VALLEY COMMONS DRIVE SUITE 104
    BOZEMAN, MT
    ZIP 59718
  • Facility Phone: 406 404-1525
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TERRY S. EDWARDS
  • NPI Number: 1477020824
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 27D2159316
LAB Type Physician Office
Facility Name BOZEMAN PRIMARY CARE
Street 4535 VALLEY COMMONS DRIVE SUITE 104
City BOZEMAN
State MT
ZIP 59718
Phone 406 404-1525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Physician Office
Lab Director TERRY S. EDWARDS

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