53D2002606 CLIA NUMBER - AFTON CBOC

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Laboratory Demographics

CLIA Number: 53D2002606

Facility Name: AFTON CBOC

Facility Address:
125 S WASHINGTON STREET
AFTON, WY
ZIP 83110
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Facility Phone Number: 307 886-5266

Facility Type: Community Clinic

Certificate Type: Accreditation

NPI Number: 1235402132

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	53D2002606
LAB Type	Community Clinic
Facility Name	AFTON CBOC
Street	125 S WASHINGTON STREET
City	AFTON
State	WY
ZIP	83110
Phone	307 886-5266
CertificateType	1
CertificateEffectiveDate	1/21/2010
CertificateExpirationDate	5/22/2026
FacilityType	Accreditation

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This page was last updated on: 4/23/2024