27D2191928 CLIA NUMBER - ADVANCED PRACTICE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 27D2191928
  • Facility Name: ADVANCED PRACTICE DERMATOLOGY
  • Facility Address: 920 FRONT STREET SUITE 103
    HELENA, MT
    ZIP 59601
  • Facility Phone: 406 820-3376
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: KARA ADDISON
  • NPI Number: 1780783506
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 27D2191928
LAB Type Practitioner Other
Facility Name ADVANCED PRACTICE DERMATOLOGY
Street 920 FRONT STREET SUITE 103
City HELENA
State MT
ZIP 59601
Phone 406 820-3376
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/14/2023
Certificate Expiration Date 12/13/2025
Facility Type Practitioner Other
Lab Director KARA ADDISON

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This page was last updated on: 3/20/2025