53D1040671 CLIA NUMBER - CHEYENNE HEALTH AND WELLNESS CENTER DBA/HEALTHWORKS

Laboratory Demographics

CLIA Number: 53D1040671

Facility Name: CHEYENNE HEALTH AND WELLNESS CENTER DBA/HEALTHWORKS

Facility Address:
2508 E FOX FARM ROAD SUITE 1A
CHEYENNE, WY
ZIP 82007
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Facility Phone Number: 307 635-3618

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1538370895

Taxonomy: 385HR2060X - Respite Care
A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.

CLIA Record

Field Name	Field Value
CLIA Number	53D1040671
LAB Type	Federally Qualified Health Center
Facility Name	CHEYENNE HEALTH AND WELLNESS CENTER DBA/HEALTHWORKS
Street	2508 E FOX FARM ROAD SUITE 1A
City	CHEYENNE
State	WY
ZIP	82007
Phone	307 635-3618
CertificateType	3
CertificateEffectiveDate	5/13/2023
CertificateExpirationDate	5/12/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024