53D2189762 CLIA NUMBER - STAR VALLEY CARE CENTER

Laboratory Demographics

  • CLIA Code: 53D2189762
  • Facility Name: STAR VALLEY CARE CENTER
  • Facility Address: 130 HOSPITAL LANE
    AFTON, WY
    ZIP 83110
  • Facility Phone: 307 885-5949
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: TAMARA COTTAM
  • NPI Number: 1497394068
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 53D2189762
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name STAR VALLEY CARE CENTER
Street 130 HOSPITAL LANE
City AFTON
State WY
ZIP 83110
Phone 307 885-5949
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2024
Certificate Expiration Date 8/4/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director TAMARA COTTAM

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This page was last updated on: 3/20/2025