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53D2116131 CLIA NUMBER - WIND RIVER JOB CORPS

Laboratory Demographics

CLIA Number: 53D2116131

Facility Name: WIND RIVER JOB CORPS

Facility Address:
4200 AIRPORT RD
RIVERTON, WY
ZIP 82501
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Facility Phone Number: 307 857-9767

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver
NPI Number: 1457893737

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name Field Value
CLIA Number 53D2116131
LAB Type Federally Qualified Health Center
Facility Name WIND RIVER JOB CORPS
Street 4200 AIRPORT RD
City RIVERTON
State WY
ZIP 82501
Phone 307 857-9767
CertificateType 4
CertificateEffectiveDate 7/20/2022
CertificateExpirationDate 7/19/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024