53D0903718 CLIA NUMBER - CAMPBELL COUNTY MEMORIAL HOSPITAL HOME HEALTH

Laboratory Demographics

  • CLIA Code: 53D0903718
  • Facility Name: CAMPBELL COUNTY MEMORIAL HOSPITAL HOME HEALTH
  • Facility Address: 300 SOUTH BURMA AVENUE
    GILLETTE, WY
    ZIP 82716
  • Facility Phone: 307 688-6230
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ASHLEY FRASER
  • NPI Number: 1851472955
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 53D0903718
LAB Type Home Health Agency
Facility Name CAMPBELL COUNTY MEMORIAL HOSPITAL HOME HEALTH
Street 300 SOUTH BURMA AVENUE
City GILLETTE
State WY
ZIP 82716
Phone 307 688-6230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2024
Certificate Expiration Date 7/8/2026
Facility Type Home Health Agency
Lab Director ASHLEY FRASER

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