53D1081744 CLIA NUMBER - WIND RIVER PEDIATRICS

Laboratory Demographics

  • CLIA Code: 53D1081744
  • Facility Name: WIND RIVER PEDIATRICS
  • Facility Address: 1005 COLLEGE VIEW DRIVE
    RIVERTON, WY
    ZIP 82501
  • Facility Phone: 307 857-5247
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: MICHAEL FISHER
  • NPI Number: 1215976253
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 53D1081744
LAB Type Mobile Laboratory
Facility Name WIND RIVER PEDIATRICS
Street 1005 COLLEGE VIEW DRIVE
City RIVERTON
State WY
ZIP 82501
Phone 307 857-5247
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2024
Certificate Expiration Date 3/24/2026
Facility Type Mobile Laboratory
Lab Director MICHAEL FISHER

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