53D2022866 CLIA NUMBER - S48WY1 LLC, DBA/WYOMING RECOVERY

Laboratory Demographics

  • CLIA Code: 53D2022866
  • Facility Name: S48WY1 LLC, DBA/WYOMING RECOVERY
  • Facility Address: 231 S WILSON ST
    CASPER, WY
    ZIP 82601
  • Facility Phone: 307 265-3791
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THOMAS RADOSEVICH
  • NPI Number: 1891994950
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 53D2022866
LAB Type Physician Office
Facility Name S48WY1 LLC, DBA/WYOMING RECOVERY
Street 231 S WILSON ST
City CASPER
State WY
ZIP 82601
Phone 307 265-3791
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2025
Certificate Expiration Date 4/10/2027
Facility Type Physician Office
Lab Director THOMAS RADOSEVICH

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