53D0954636 CLIA NUMBER - CENTRAL WYOMING SKIN CLINIC

Laboratory Demographics

  • CLIA Code: 53D0954636
  • Facility Name: CENTRAL WYOMING SKIN CLINIC
  • Facility Address: 2546 E 2ND ST SUITE 400 SUITE 400
    CASPER, WY
    ZIP 82609
  • Facility Phone: 307 234-0003
  • Facility Type: Practitioner Other
  • Facility Type: Certificate of Compliance
  • Lab Director: MATTHEW R. GREEN
  • NPI Number: 1386672996
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 53D0954636
LAB Type Practitioner Other
Facility Name CENTRAL WYOMING SKIN CLINIC
Street 2546 E 2ND ST SUITE 400 SUITE 400
City CASPER
State WY
ZIP 82609
Phone 307 234-0003
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Practitioner Other
Lab Director MATTHEW R. GREEN

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