53D2060215 CLIA NUMBER - EDEN VALLEY TELEHEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 53D2060215
  • Facility Name: EDEN VALLEY TELEHEALTH SERVICES
  • Facility Address: #5 HIGHWAY 28
    FARSON, WY
    ZIP 82932
  • Facility Phone: 307 273-3055
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: MS. MARY ANNE MINES
  • NPI Number: 1730425471
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 53D2060215
LAB Type Rural Health Clinic
Facility Name EDEN VALLEY TELEHEALTH SERVICES
Street #5 HIGHWAY 28
City FARSON
State WY
ZIP 82932
Phone 307 273-3055
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Rural Health Clinic
Lab Director MS. MARY ANNE MINES

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