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PINE BLUFFS CLINIC
NPI 1316340417
Clinic/Center - Federally Qualified Health Center (FQHC) in Pine Bluffs, WY

Active since October 02, 2014CLIA Certified · 2 labs
117 E 4TH ST, PINE BLUFFS, WY 82082(307) 245-3666 Get Directions Write a Review

NPPES record last updated: April 13, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Pine Bluffs Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINE BLUFFS CLINIC (NPI 1316340417) is a healthcare organization registered as a federally qualified health center (fqhc) in Pine Bluffs, Wyoming and active in the NPI registry since October 2014. The organization holds 2 active CLIA laboratory certificates and lists Ronald Malm, Program Director, as its authorized official.

NPPES Registry Identity

NPI1316340417
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameUNIVERSITY OF WYOMING
Location Address117 E 4TH STPine Bluffs, WY 82082
Mailing Address820 E 17th StCheyenne, WY 82001-4714 · (307) 245-3666
Phone(307) 245-3666
Organization SubpartYes
Authorized OfficialRonald MalmProgram Director · (307) 632-2434
Enumeration DateOctober 2, 2014
Last NPPES UpdateApril 13, 2016
✔ NPI 1316340417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedClinic/CenterTaxonomy 261Q00000X
117 E 4TH ST, Pine Bluffs, WY 82082
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Other Names 1

Other NamePine Bluffs Clinic

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 53D0519699

University Of Wyoming Family Medicine · Cheyenne, WY
Active · expires Nov 5, 2027
CLIA Number53D0519699
Laboratory TypePhysician Office
Certificate Effective DateNovember 6, 2025
Certificate Expiration DateNovember 5, 2027
Laboratory DirectorKylie J. Caraway
Laboratory Phone(307) 632-2434
Laboratory LocationUniversity Of Wyoming Family Medicine820 E 17th Street, Cheyenne, WY 82001
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 53D2026171

University Of Wyoming Family Practice, The · Casper, WY
Active · expires Jan 15, 2027
CLIA Number53D2026171
Laboratory TypePhysician Office
Certificate Effective DateJanuary 16, 2025
Certificate Expiration DateJanuary 15, 2027
Laboratory DirectorMs. Kylie J. Caraway
Laboratory Phone(307) 632-2434
Laboratory LocationUniversity Of Wyoming Family Practice, The1522 East A Street, Casper, WY 82601
CLIA data matches this NPI record on: Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIMBALL COUNTY HOSPITAL
Clinic/Center (Rural Health)
117 E 4TH ST
PINE BLUFFS, WY 82082
Laramie County (307) 245-3666
NICOLE CHRISTINE RASMUSSEN APRN
Nurse Practitioner
117 E 4TH ST
PINE BLUFFS, WY 82082
Laramie County (307) 245-3666

Frequently Asked Questions

What is UNIVERSITY OF WYOMING's NPI number?

The NPI number assigned to this healthcare provider is 1316340417, enumerated as an "organization" on October 02, 2014.

Where is the provider located?

The provider is located at 117 E 4TH ST PINE BLUFFS, WY 82082 and the phone number is (307) 245-3666.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).