53D2115216 CLIA NUMBER - SUMMIT OB GYN PC

Laboratory Demographics

  • CLIA Code: 53D2115216
  • Facility Name: SUMMIT OB GYN PC
  • Facility Address: 1414 W FOURTH ST
    GILLETTE, WY
    ZIP 82716
  • Facility Phone: 307 299-4496
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANGELA E. BIGGS
  • NPI Number: 1942664107
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 53D2115216
LAB Type Physician Office
Facility Name SUMMIT OB GYN PC
Street 1414 W FOURTH ST
City GILLETTE
State WY
ZIP 82716
Phone 307 299-4496
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/30/2024
Certificate Expiration Date 6/29/2026
Facility Type Physician Office
Lab Director ANGELA E. BIGGS

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