53D0952972 CLIA NUMBER - STATE OF WYOMING WIC PROGRAM

Laboratory Demographics

  • CLIA Code: 53D0952972
  • Facility Name: STATE OF WYOMING WIC PROGRAM
  • Facility Address: 122 W 25TH ST, 3RD FL WEST
    CHEYENNE, WY
    ZIP 82002
  • Facility Phone: 307 777-6009
  • Facility Type: Public Health Laboratories
  • Facility Type: Waiver
  • Lab Director: JOSEPH M. REED
  • NPI Number: 1366634396
  • Taxonomy: 251K00000X - Public Health or Welfare

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CLIA Record

Field Name Field Value
CLIA Number 53D0952972
LAB Type Public Health Laboratories
Facility Name STATE OF WYOMING WIC PROGRAM
Street 122 W 25TH ST, 3RD FL WEST
City CHEYENNE
State WY
ZIP 82002
Phone 307 777-6009
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Public Health Laboratories
Lab Director JOSEPH M. REED

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