| Organization Name: | CHEYENNE HISTOLOGY |
| NPI Number: | 1023258670 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAFANG YUAN (MANAGER) |
| Mailing Address: | 1414 Campbell Ave Cheyenne |
| State: | WY US |
| Postal Code: | 820015119 |
| Phone Number: | 3074594169 |
| Fax Number: | |
| NPI Enumeration Date: | 02/23/2009 |
| NPI Last Update Date: | 02/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246RH0600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Technician, Pathology |
| Taxonomy Specialization: | Histology |
| Taxonomy Definition: | |