53D0670606 CLIA NUMBER - TETON PATHOLOGY PC

Laboratory Demographics

  • CLIA Code: 53D0670606
  • Facility Name: TETON PATHOLOGY PC
  • Facility Address: 625 E BROADWAY
    JACKSON, WY
    ZIP 83001
  • Facility Phone: 307 739-7340
  • Facility Type: Hospital
  • Facility Type: Accreditation
  • Lab Director: DR. EDWARD J. CALLAGHAN
  • NPI Number: 1780027953
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 53D0670606
LAB Type Hospital
Facility Name TETON PATHOLOGY PC
Street 625 E BROADWAY
City JACKSON
State WY
ZIP 83001
Phone 307 739-7340
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 9/3/2024
Certificate Expiration Date 9/2/2026
Facility Type Hospital
Lab Director DR. EDWARD J. CALLAGHAN

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