53D2169198 CLIA NUMBER - SOUTH STREET PHARMACY

Laboratory Demographics

  • CLIA Code: 53D2169198
  • Facility Name: SOUTH STREET PHARMACY
  • Facility Address: 1456 SOUTH STREET
    WHEATLAND, WY
    ZIP 82201
  • Facility Phone: 307 322-2486
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CORINDA GEILE
  • NPI Number: 1639482532
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 53D2169198
LAB Type Pharmacy
Facility Name SOUTH STREET PHARMACY
Street 1456 SOUTH STREET
City WHEATLAND
State WY
ZIP 82201
Phone 307 322-2486
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2025
Certificate Expiration Date 7/16/2027
Facility Type Pharmacy
Lab Director CORINDA GEILE

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