53D2186453 CLIA NUMBER - RAWHIDE DRUG

Laboratory Demographics

  • CLIA Code: 53D2186453
  • Facility Name: RAWHIDE DRUG
  • Facility Address: 232 S MAIN ST
    LUSK, WY
    ZIP 82225
  • Facility Phone: 307 334-3132
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMIE HALE
  • NPI Number: 1124779392
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 53D2186453
LAB Type Pharmacy
Facility Name RAWHIDE DRUG
Street 232 S MAIN ST
City LUSK
State WY
ZIP 82225
Phone 307 334-3132
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2024
Certificate Expiration Date 6/16/2026
Facility Type Pharmacy
Lab Director JAMIE HALE

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