37D2087356 CLIA NUMBER - ALBERT HALL FAIRCHILD HOME & COMMUNITY BASED SERVICES

Laboratory Demographics

  • CLIA Code: 37D2087356
  • Facility Name: ALBERT HALL FAIRCHILD HOME & COMMUNITY BASED SERVICES
  • Facility Address: 205 E MAPLE
    BILLINGS, OK
    ZIP 74630
  • Facility Phone: 580 725-3400
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: JAMI BENTON
  • NPI Number: 1407240237
  • Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities

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CLIA Record

Field Name Field Value
CLIA Number 37D2087356
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name ALBERT HALL FAIRCHILD HOME & COMMUNITY BASED SERVICES
Street 205 E MAPLE
City BILLINGS
State OK
ZIP 74630
Phone 580 725-3400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2024
Certificate Expiration Date 11/20/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director JAMI BENTON

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