53D0977879 CLIA NUMBER - TETON OUTPATIENT SERVICES LLC

Laboratory Demographics

  • CLIA Code: 53D0977879
  • Facility Name: TETON OUTPATIENT SERVICES LLC
  • Facility Address: 150 BUFFALO WAY
    JACKSON, WY
    ZIP 83001
  • Facility Phone: 307 733-8677
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MATTHEW W. ZELEZNIK
  • NPI Number: 1689651481
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 53D0977879
LAB Type Ambulatory Surgery Center
Facility Name TETON OUTPATIENT SERVICES LLC
Street 150 BUFFALO WAY
City JACKSON
State WY
ZIP 83001
Phone 307 733-8677
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2024
Certificate Expiration Date 9/7/2026
Facility Type Ambulatory Surgery Center
Lab Director MATTHEW W. ZELEZNIK

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