53D1068544 CLIA NUMBER - SHOSHONE & ARAPAHO HEADSTART 0-5 PROG

Laboratory Demographics

  • CLIA Code: 53D1068544
  • Facility Name: SHOSHONE & ARAPAHO HEADSTART 0-5 PROG
  • Facility Address: #79 SACAJAWEA CIRCLE
    FORT WASHAKIE, WY
    ZIP 82514
  • Facility Phone: 307 332-7163
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: ANGELICA JAURE
  • NPI Number: 1558425207
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 53D1068544
LAB Type School/Student Health Service
Facility Name SHOSHONE & ARAPAHO HEADSTART 0-5 PROG
Street #79 SACAJAWEA CIRCLE
City FORT WASHAKIE
State WY
ZIP 82514
Phone 307 332-7163
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2025
Certificate Expiration Date 5/14/2027
Facility Type School/Student Health Service
Lab Director ANGELICA JAURE

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