53D2329633 CLIA NUMBER - CASPER MEDICAL IMAGING OUTPATIENT RADIOLOGY EAST CAMPUS

Laboratory Demographics

  • CLIA Code: 53D2329633
  • Facility Name: CASPER MEDICAL IMAGING OUTPATIENT RADIOLOGY EAST CAMPUS
  • Facility Address: 6600 E 2ND STREET SUITE E
    CASPER, WY
    ZIP 82609
  • Facility Phone: 307 232-5030
  • Facility Type: Other - OUTPATIENT RADIOLOGY CLIN
  • Facility Type: Waiver
  • Lab Director: KIMBERLY B. ELLIOTT
  • NPI Number: 1518178359
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 53D2329633
LAB Type Other - OUTPATIENT RADIOLOGY CLIN
Facility Name CASPER MEDICAL IMAGING OUTPATIENT RADIOLOGY EAST CAMPUS
Street 6600 E 2ND STREET SUITE E
City CASPER
State WY
ZIP 82609
Phone 307 232-5030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2025
Certificate Expiration Date 9/2/2027
Facility Type Other - OUTPATIENT RADIOLOGY CLIN
Lab Director KIMBERLY B. ELLIOTT

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