53D2116131 CLIA NUMBER - WIND RIVER JOB CORPS

Laboratory Demographics

  • CLIA Code: 53D2116131
  • Facility Name: WIND RIVER JOB CORPS
  • Facility Address: 4200 AIRPORT RD
    RIVERTON, WY
    ZIP 82501
  • Facility Phone: 307 857-9767
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: KRISTY M. CARDINAL
  • NPI Number: 1457893737
  • Taxonomy: 251S00000X - Community/Behavioral Health

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Federally Qualified Health Center
Lab Director KRISTY M. CARDINAL

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