53D2108851 CLIA NUMBER - CITY MARKET PHARMACY #412

Laboratory Demographics

  • CLIA Code: 53D2108851
  • Facility Name: CITY MARKET PHARMACY #412
  • Facility Address: 602 N HIGLEY BLVD
    RAWLINS, WY
    ZIP 82301
  • Facility Phone: 307 324-3084
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY WARD
  • NPI Number: 1053347245
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 53D2108851
LAB Type Pharmacy
Facility Name CITY MARKET PHARMACY #412
Street 602 N HIGLEY BLVD
City RAWLINS
State WY
ZIP 82301
Phone 307 324-3084
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2024
Certificate Expiration Date 2/11/2026
Facility Type Pharmacy
Lab Director KIMBERLY WARD

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