# CENTRAL MT LABORATORY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023345949
- **Authorized official:** MS. LILA GOODAU (OFFICE MANAGER)
- **Authorized official phone:** (406) 454-1211

## Contact information

- **Practice address:** 3511 1ST AVE N, GREAT FALLS, MT 59401-3527
- **Practice address phone:** (406) 454-1211
- **Practice address fax:** (406) 454-9916
- **Mailing address:** 3511 1ST AVE N, GREAT FALLS, MT 59401-3527
- **Mailing address phone:** (406) 454-1211
- **Mailing address fax:** (406) 454-9916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 8293 | MT | Yes |

## Other

- **Enumeration date:** 11/13/2009
- **Last updated:** 11/13/2009