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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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Physiological Laboratory, (Independent Physiological Lab) |
293D00000X | 47 | Independent Diagnostic Testing Facility (IDTF) | |
EEG |
2472E0500X | 75 | Slide Preparation Facility | |
Electroneurodiagnostic |
246ZE0600X |
| NPI # | 1285153593 |
| LBN Legal business name | SYNERGIST LABORATORIES, LLC |
| Authorized official | MATTHEW WAVRA - (PARTNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/18/2017 |
| Last updated | 03/22/2018 - About 8 years ago |
| Identifiers | n/a |
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| SYNERGIST MONITORING LLC 1910 THOMES AVE CHEYENNE, WY |
| KYLIE G DOMINICK 1025 PENNOCK PLACE FORT COLINS, CO |
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| ELISABETH HEUSINGFELD 389 ADAMS ST AFTON, WY |
| JONAH J GREEN, MD 110 HOSPITAL LN AFTON, WY |
SYNERGIST LABORATORIES, LLC