53D2052655 CLIA NUMBER - CHIROPRACTIC WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 53D2052655
  • Facility Name: CHIROPRACTIC WELLNESS CENTER
  • Facility Address: 207 S OSBORNE AVE
    GILLETTE, WY
    ZIP 82716
  • Facility Phone: 307 682-4000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MS. KIRSTEN K. MAYCOCK
  • NPI Number: 1659566974
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 53D2052655
LAB Type Physician Office
Facility Name CHIROPRACTIC WELLNESS CENTER
Street 207 S OSBORNE AVE
City GILLETTE
State WY
ZIP 82716
Phone 307 682-4000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2025
Certificate Expiration Date 1/14/2027
Facility Type Physician Office
Lab Director MS. KIRSTEN K. MAYCOCK

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