53D2308451 CLIA NUMBER - SUMMIT RELIEF JH LLC

Laboratory Demographics

  • CLIA Code: 53D2308451
  • Facility Name: SUMMIT RELIEF JH LLC
  • Facility Address: 320 E BROADWAY AVE UNIT 1A
    JACKSON, WY
    ZIP 83001
  • Facility Phone: 307 289-2525
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CARRIE R. QUINLAN
  • NPI Number: 1801641139
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 53D2308451
LAB Type Physician Office
Facility Name SUMMIT RELIEF JH LLC
Street 320 E BROADWAY AVE UNIT 1A
City JACKSON
State WY
ZIP 83001
Phone 307 289-2525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type Physician Office
Lab Director CARRIE R. QUINLAN

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