53D2110344 CLIA NUMBER - GRANITE REHABILITATION AND WELLNESS

Laboratory Demographics

  • CLIA Code: 53D2110344
  • Facility Name: GRANITE REHABILITATION AND WELLNESS
  • Facility Address: 3128 BOXELDER DRIVE
    CHEYENNE, WY
    ZIP 82001
  • Facility Phone: 307 634-7901
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JOHN H. BABSON
  • NPI Number: 1093190688
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 53D2110344
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GRANITE REHABILITATION AND WELLNESS
Street 3128 BOXELDER DRIVE
City CHEYENNE
State WY
ZIP 82001
Phone 307 634-7901
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2024
Certificate Expiration Date 3/13/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JOHN H. BABSON

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