53D1073598 CLIA NUMBER - CHEYENNE OCULAR SURGERY LLC

Laboratory Demographics

  • CLIA Code: 53D1073598
  • Facility Name: CHEYENNE OCULAR SURGERY LLC
  • Facility Address: 1300 E 20TH STREET
    CHEYENNE, WY
    ZIP 82001
  • Facility Phone: (307) 632-2020
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. RANDOLPH L. JOHNSTON
  • NPI Number: 1326247479
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 53D1073598
LAB Type Ambulatory Surgery Center
Facility Name CHEYENNE OCULAR SURGERY LLC
Street 1300 E 20TH STREET
City CHEYENNE
State WY
ZIP 82001
Phone 3076322020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. RANDOLPH L. JOHNSTON

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This page was last updated on: 5/18/2026