53D2318303 CLIA NUMBER - LITTLE SNAKE RIVER CLINIC

Laboratory Demographics

  • CLIA Code: 53D2318303
  • Facility Name: LITTLE SNAKE RIVER CLINIC
  • Facility Address: 15 LASH ST
    BAGGS, WY
    ZIP 82321
  • Facility Phone: 307 383-2008
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES R. ZIMMERMAN
  • NPI Number: 1336950591
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 53D2318303
LAB Type Physician Office
Facility Name LITTLE SNAKE RIVER CLINIC
Street 15 LASH ST
City BAGGS
State WY
ZIP 82321
Phone 307 383-2008
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2025
Certificate Expiration Date 2/6/2027
Facility Type Physician Office
Lab Director JAMES R. ZIMMERMAN

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