53D2006934 CLIA NUMBER - CRMG INTERNAL AND FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 53D2006934
  • Facility Name: CRMG INTERNAL AND FAMILY MEDICINE
  • Facility Address: 800 EAST 20TH STREET, SUITE 200
    CHEYENNE, WY
    ZIP 82001
  • Facility Phone: 307 633-7444
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAMUEL HART
  • NPI Number: 1982362141
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 53D2006934
LAB Type Physician Office
Facility Name CRMG INTERNAL AND FAMILY MEDICINE
Street 800 EAST 20TH STREET, SUITE 200
City CHEYENNE
State WY
ZIP 82001
Phone 307 633-7444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2024
Certificate Expiration Date 5/3/2026
Facility Type Physician Office
Lab Director SAMUEL HART

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