53D1099140 CLIA NUMBER - PLATTE RIVER FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 53D1099140
  • Facility Name: PLATTE RIVER FAMILY PRACTICE
  • Facility Address: 1900 E 1ST ST
    CASPER, WY
    ZIP 82601
  • Facility Phone: 307 577-7737
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: AMY M. GRUWELL
  • NPI Number: 1942443536
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 53D1099140
LAB Type Practitioner Other
Facility Name PLATTE RIVER FAMILY PRACTICE
Street 1900 E 1ST ST
City CASPER
State WY
ZIP 82601
Phone 307 577-7737
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 5/6/2025
Certificate Expiration Date 5/5/2027
Facility Type Practitioner Other
Lab Director AMY M. GRUWELL

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