53D0520026 CLIA NUMBER - GLENROCK HOSPITAL DISTRICT DBA GLENROCK HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 53D0520026
  • Facility Name: GLENROCK HOSPITAL DISTRICT DBA GLENROCK HEALTH CENTER
  • Facility Address: 925 WEST BIRCH STREET
    GLENROCK, WY
    ZIP 82637
  • Facility Phone: 307 436-9206
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: DR. JOSEPH E. MICKELSON
  • NPI Number: 1922470293
  • Taxonomy: 1223G0001X - Dentist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 53D0520026
LAB Type Rural Health Clinic
Facility Name GLENROCK HOSPITAL DISTRICT DBA GLENROCK HEALTH CENTER
Street 925 WEST BIRCH STREET
City GLENROCK
State WY
ZIP 82637
Phone 307 436-9206
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/29/2025
Certificate Expiration Date 9/28/2027
Facility Type Rural Health Clinic
Lab Director DR. JOSEPH E. MICKELSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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