53D2258246 CLIA NUMBER - HOMETOWN FREEDOM HEALTHCARE LLC

Laboratory Demographics

  • CLIA Code: 53D2258246
  • Facility Name: HOMETOWN FREEDOM HEALTHCARE LLC
  • Facility Address: 705 E WASHINGTON AVENUE
    RIVERTON, WY
    ZIP 82501
  • Facility Phone: 307 438-0541
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: TARA BLUMENSHINE
  • NPI Number: 1730608860
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 53D2258246
LAB Type Community Clinic
Facility Name HOMETOWN FREEDOM HEALTHCARE LLC
Street 705 E WASHINGTON AVENUE
City RIVERTON
State WY
ZIP 82501
Phone 307 438-0541
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/19/2024
Certificate Expiration Date 4/18/2026
Facility Type Community Clinic
Lab Director TARA BLUMENSHINE

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