53D2177934 CLIA NUMBER - PIONEER PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 53D2177934
  • Facility Name: PIONEER PHARMACY LLC
  • Facility Address: 832 W MAIN ST
    RIVERTON, WY
    ZIP 82501
  • Facility Phone: (307) 463-8400
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SOMMER J. PEDERSEN
  • NPI Number: 1508426081
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 53D2177934
LAB Type Pharmacy
Facility Name PIONEER PHARMACY LLC
Street 832 W MAIN ST
City RIVERTON
State WY
ZIP 82501
Phone 3074638400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2026
Certificate Expiration Date 1/21/2028
Facility Type Pharmacy
Lab Director SOMMER J. PEDERSEN

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This page was last updated on: 5/18/2026