THE LAB, LLC
NPI 1609463819
Physiological Laboratory in Jackson, WY

Active since December 22, 2020CLIA Certified · 4 labs
625 E BROADWAY AVE, JACKSON, WY 83001(307) 920-1688 Get Directions Write a Review

NPPES record last updated: May 23, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 23, 2021, Dec 22, 2020 (2 updates tracked since 2020).

About The Lab, Llc NPPES

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

THE LAB, LLC (NPI 1609463819) is a healthcare organization registered as a physiological laboratory in Jackson, Wyoming and active in the NPI registry since December 2020. The organization holds a CLIA Waiver certificate valid through August 27, 2027 and lists Austin Hammesfahr, Manager, as its authorized official.

NPPES Registry Identity

NPI1609463819
Entity TypeOrganization
Primary Taxonomy293D00000X
Legal Business NameTHE LAB, LLC
Location Address625 E BROADWAY AVEJackson, WY 83001-8642
Mailing Address522 N Sweetzer Ave Apt 5Los Angeles, CA 90048-2659 · (310) 307-9670
Organization SubpartNo
Authorized OfficialAustin HammesfahrManager · (310) 307-9670
Enumeration DateDecember 22, 2020
Last NPPES UpdateMay 23, 20212 updates tracked since enumeration
NPPES CertifiedMay 23, 2021
NPI 1609463819 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysiological LaboratoryLaboratories
Taxonomy Code293D00000X
Definition

A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.

625 E BROADWAY AVE, Jackson, WY 83001

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2329461
Facility Type
Home Health Agency
Certificate Effective Date
August 28, 2025
Certificate Expiration Date
August 27, 2027
Laboratory Director
ARIELLA MORROW
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to The Lab, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Clinical Medical Laboratory
625 E BROADWAY AVE
JACKSON, WY 83001
Dietitian, Registered
625 E BROADWAY AVE, SUITE 114
JACKSON, WY 83001
Nurse Anesthetist, Certified Registered
625 E BROADWAY AVE
JACKSON, WY 83001
Nurse Anesthetist, Certified Registered
625 E BROADWAY AVE
JACKSON, WY 83001
Nurse Anesthetist, Certified Registered
625 E BROADWAY AVE
JACKSON, WY 83001
Emergency Medicine
625 E BROADWAY AVE
JACKSON HOLE, WY 83001
Occupational Therapist
625 E BROADWAY AVE
JACKSON, WY 83001
Speech-Language Pathologist
625 E BROADWAY AVE
JACKSON, WY 83001
Specialist/Technologist, Other
625 E BROADWAY AVE
JACKSON, WY 83001
Radiology (Diagnostic Radiology)
625 E BROADWAY AVE
JACKSON, WY 83001
Registered Nurse (Registered Nurse First Assistant)
625 E BROADWAY AVE
JACKSON, WY 83001
Pharmacy (Institutional Pharmacy)
625 E BROADWAY AVE
JACKSON, WY 83001
Physical Therapy Assistant
625 E BROADWAY AVE
JACKSON, WY 83001
Physical Therapy Assistant
625 E BROADWAY AVE
JACKSON, WY 83001
Registered Nurse (Registered Nurse First Assistant)
625 E BROADWAY AVE
JACKSON, WY 83001
Occupational Therapist (Gerontology)
625 E BROADWAY AVE
JACKSON, WY 83001
Pathology (Anatomic Pathology & Clinical Pathology)
625 E BROADWAY AVE
JACKSON, WY 83001
Nurse Practitioner (Acute Care)
625 E BROADWAY AVE
JACKSON, WY 83001
Nurse Practitioner
625 E BROADWAY AVE
JACKSON, WY 83001
Nurse Practitioner (Family)
625 E BROADWAY AVE
JACKSON, WY 83001

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609463819, enumerated as an "organization" on December 22, 2020.

The provider is located at 625 E BROADWAY AVE JACKSON, WY 83001 and the phone number is (307) 920-1688.

Physiological Laboratory with taxonomy code 293D00000X.