53D0520026 CLIA NUMBER - GLENROCK HEALTH CENTER

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Laboratory Demographics

CLIA Number: 53D0520026

Facility Name: GLENROCK HEALTH CENTER

Facility Address:
925 WEST BIRCH STREET
GLENROCK, WY
ZIP 82637
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Facility Phone Number: 307 436-9206

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1922470293

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	53D0520026
LAB Type	Community Clinic
Facility Name	GLENROCK HEALTH CENTER
Street	925 WEST BIRCH STREET
City	GLENROCK
State	WY
ZIP	82637
Phone	307 436-9206
CertificateType	3
CertificateEffectiveDate	9/29/2023
CertificateExpirationDate	9/28/2025
FacilityType	PPMP

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