53D2189205 CLIA NUMBER - CITY DRUG

Laboratory Demographics

  • CLIA Code: 53D2189205
  • Facility Name: CITY DRUG
  • Facility Address: 131 10TH STREET
    EVANSTON, WY
    ZIP 82930
  • Facility Phone: 307 789-4000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW CANNON
  • NPI Number: 1770043234
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 53D2189205
LAB Type Pharmacy
Facility Name CITY DRUG
Street 131 10TH STREET
City EVANSTON
State WY
ZIP 82930
Phone 307 789-4000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2024
Certificate Expiration Date 7/27/2026
Facility Type Pharmacy
Lab Director ANDREW CANNON

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