53D2178536 CLIA NUMBER - AFFINITY FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 53D2178536
  • Facility Name: AFFINITY FAMILY PRACTICE
  • Facility Address: 903 S GREELEY HWY STE A
    CHEYENNE, WY
    ZIP 82007
  • Facility Phone: (307) 514-1523
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SHERIDAN E. GRANNAN
  • NPI Number: 1255970034
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 53D2178536
LAB Type Practitioner Other
Facility Name AFFINITY FAMILY PRACTICE
Street 903 S GREELEY HWY STE A
City CHEYENNE
State WY
ZIP 82007
Phone 3075141523
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2026
Certificate Expiration Date 2/3/2028
Facility Type Practitioner Other
Lab Director SHERIDAN E. GRANNAN

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