27D2229922 CLIA NUMBER - MILES CITY CLINIC - OCCUPATIONAL HEALTH X

Laboratory Demographics

CLIA Number: 27D2229922

Facility Name: MILES CITY CLINIC - OCCUPATIONAL HEALTH X

Facility Address:
2600 WILSON STREET
MILES CITY, MT
ZIP 59301
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Facility Phone Number: 406 233-5438

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124490529

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	27D2229922
LAB Type	Physician Office
Facility Name	MILES CITY CLINIC - OCCUPATIONAL HEALTH X
Street	2600 WILSON STREET
City	MILES CITY
State	MT
ZIP	59301
Phone	406 233-5438
CertificateType	4
CertificateEffectiveDate	7/19/2023
CertificateExpirationDate	7/18/2025
FacilityType	Waiver

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