53D0910380 CLIA NUMBER - ST JOHN'S FAMILY HEALTH AND URGENT CARE

Laboratory Demographics

  • CLIA Code: 53D0910380
  • Facility Name: ST JOHN'S FAMILY HEALTH AND URGENT CARE
  • Facility Address: 1415 SOUTH HIGHWAY 89
    JACKSON, WY
    ZIP 83001
  • Facility Phone: 307 739-8999
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JAMES R. LITTLE JR
  • NPI Number: 1679859797
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 53D0910380
LAB Type Physician Office
Facility Name ST JOHN'S FAMILY HEALTH AND URGENT CARE
Street 1415 SOUTH HIGHWAY 89
City JACKSON
State WY
ZIP 83001
Phone 307 739-8999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type Physician Office
Lab Director DR. JAMES R. LITTLE JR

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