53D1045555 CLIA NUMBER - OSCO PHARMACY #0064

Laboratory Demographics

  • CLIA Code: 53D1045555
  • Facility Name: OSCO PHARMACY #0064
  • Facility Address: 1865 COFFEEN AVE
    SHERIDAN, WY
    ZIP 82801
  • Facility Phone: 307 672-8908
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALISHA WRIGHT
  • NPI Number: 1225212723
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 53D1045555
LAB Type Pharmacy
Facility Name OSCO PHARMACY #0064
Street 1865 COFFEEN AVE
City SHERIDAN
State WY
ZIP 82801
Phone 307 672-8908
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2023
Certificate Expiration Date 9/15/2025
Facility Type Pharmacy
Lab Director ALISHA WRIGHT

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This page was last updated on: 3/20/2025