53D2320191 CLIA NUMBER - WYOMING ORTHOPEDICS & SPINE

Laboratory Demographics

  • CLIA Code: 53D2320191
  • Facility Name: WYOMING ORTHOPEDICS & SPINE
  • Facility Address: 508 STOCKTRAIL STE A
    GILLETTE, WY
    ZIP 82716
  • Facility Phone: 307 686-1413
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STANFORD T. ISRAELSON
  • NPI Number: 1447512959
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 53D2320191
LAB Type Physician Office
Facility Name WYOMING ORTHOPEDICS & SPINE
Street 508 STOCKTRAIL STE A
City GILLETTE
State WY
ZIP 82716
Phone 307 686-1413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/13/2025
Certificate Expiration Date 3/12/2027
Facility Type Physician Office
Lab Director STANFORD T. ISRAELSON

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