27D2167869 CLIA NUMBER - EXPRESS CARE SOUTHGATE

Laboratory Demographics

  • CLIA Code: 27D2167869
  • Facility Name: EXPRESS CARE SOUTHGATE
  • Facility Address: 2624 BROOKS STREET, STE 101
    MISSOULA, MT
    ZIP 59801
  • Facility Phone: 888 227-3312
  • Facility Type: Other - EXPRESS CARE
  • Facility Type: Waiver
  • Lab Director: OLUBANKE BABALOLA
  • NPI Number: 1205499126
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 27D2167869
LAB Type Other - EXPRESS CARE
Facility Name EXPRESS CARE SOUTHGATE
Street 2624 BROOKS STREET, STE 101
City MISSOULA
State MT
ZIP 59801
Phone 888 227-3312
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Other - EXPRESS CARE
Lab Director OLUBANKE BABALOLA

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