53D1045559 CLIA NUMBER - OSCO PHARMACY #0067

Laboratory Demographics

  • CLIA Code: 53D1045559
  • Facility Name: OSCO PHARMACY #0067
  • Facility Address: 2610 S DOUGLAS HWY
    GILLETTE, WY
    ZIP 82716
  • Facility Phone: 307 687-2996
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNA SLOAN
  • NPI Number: 1770767279
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 53D1045559
LAB Type Pharmacy
Facility Name OSCO PHARMACY #0067
Street 2610 S DOUGLAS HWY
City GILLETTE
State WY
ZIP 82716
Phone 307 687-2996
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2025
Certificate Expiration Date 9/15/2027
Facility Type Pharmacy
Lab Director JENNA SLOAN

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