27D2314100 CLIA NUMBER - CREDENA HEALTH PHARMACY LAKESHORE

Laboratory Demographics

  • CLIA Code: 27D2314100
  • Facility Name: CREDENA HEALTH PHARMACY LAKESHORE
  • Facility Address: 50331 US HWY 93
    POLSON, MT
    ZIP 59860
  • Facility Phone: 406 883-0342
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTIN JOHNSON-DOBLE
  • NPI Number: 1164809778
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 27D2314100
LAB Type Pharmacy
Facility Name CREDENA HEALTH PHARMACY LAKESHORE
Street 50331 US HWY 93
City POLSON
State MT
ZIP 59860
Phone 406 883-0342
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2024
Certificate Expiration Date 11/12/2026
Facility Type Pharmacy
Lab Director KRISTIN JOHNSON-DOBLE

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