53D2295746 CLIA NUMBER - WYOMING HEART AND VASCULAR CENTER

Laboratory Demographics

CLIA Number: 53D2295746

Facility Name: WYOMING HEART AND VASCULAR CENTER

Facility Address:
1204 HILLTOP DR, SUITE 106
ROCK SPRINGS, WY
ZIP 82901
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Facility Phone Number: 412 626-0143

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1932889482

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

CLIA Record

Field Name	Field Value
CLIA Number	53D2295746
LAB Type	Physician Office
Facility Name	WYOMING HEART AND VASCULAR CENTER
Street	1204 HILLTOP DR, SUITE 106
City	ROCK SPRINGS
State	WY
ZIP	82901
Phone	412 626-0143
CertificateType	4
CertificateEffectiveDate	12/15/2023
CertificateExpirationDate	12/14/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024