27D2267430 CLIA NUMBER - MONTANA GASTROENTEROLOGY, PLLC

Laboratory Demographics

CLIA Number: 27D2267430

Facility Name: MONTANA GASTROENTEROLOGY, PLLC

Facility Address:
1930 W BROADWAY ST, STE A
MISSOULA, MT
ZIP 59808
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Facility Phone Number: 406 541-6844

Facility Type: Community Clinic

Certificate Type: Certificate of Compliance

NPI Number: 1821612946

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	27D2267430
LAB Type	Community Clinic
Facility Name	MONTANA GASTROENTEROLOGY, PLLC
Street	1930 W BROADWAY ST, STE A
City	MISSOULA
State	MT
ZIP	59808
Phone	406 541-6844
CertificateType	2
CertificateEffectiveDate	2/9/2023
CertificateExpirationDate	2/8/2025
FacilityType	Compliance

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