FDA and state rules, for what you actually buy.

Must a pharmacy located in another state hold a license/registration from this state to ship prescriptions (including patient-specific 503A compounded preparations) to patients or practitioners here?

Wyo. Stat. §33-24-152(a) requires any pharmacy outside Wyoming that ships, mails or delivers controlled substances or prescription drugs or devices into the state under a prescription, or provides pharmaceutical care to a Wyoming resident, to obtain a Board of Pharmacy license. The pharmacy must also keep a valid home-state license and offer a toll-free line at least 6 days and 40 hours a week, printed on each label. Board Rules Ch. 19 §11 require a copy of the resident-state license, the latest resident-state inspection report, the DEA registration, the officers and registered agent, and a list of all pharmacists and technicians naming the PIC. Ch. 2 §4(b) requires a nonresident pharmacy to designate 'one registered pharmacist' as PIC, whereas resident pharmacies need a Board-licensed PIC. Unlicensed nonresident pharmacies may not advertise in Wyoming (§33-24-152(g)). No separate nonresident sterile-compounding permit was found. The Board's page states that any entity shipping prescription drugs into Wyoming must be licensed.

Renewal is annual: the statute says on or before June 30, and Ch. 19 §11(c) says by July 1. Ch. 19 dates from 2018 and could be stale, though it is still listed as current. New applications must be mailed. Changes of ownership or PIC must be reported within 30 days. The Board may discipline a nonresident pharmacy for purchasing or receiving a prescription drug that is 'not approved by the federal food and drug administration' (§33-24-152(e)(viii)); how that applies to compounding ingredients is not addressed. Board contact: bop@wyo.gov.

May a 503A (traditional) pharmacy dispense or distribute compounded preparations to a practitioner for office use (administration in the office, not patient-specific)? The federal position is that 503A requires patient-specific prescriptions; this is what the state pharmacy act and board rules allow.

Board Rules Ch. 2 §6(d) state that a prescription may not be dispensed to a practitioner on an order that is not issued for one specific patient, and that a prescription order for 'office use' is not a valid order. Ch. 2 §3(c) ties compounding to a practitioner's prescription or medication order or the practitioner/patient/pharmacist/compounder relationship, including anticipatory compounding based on regularly observed prescribing patterns. The compounding rule itself (Ch. 22, eff. Aug. 19, 2025) only incorporates USP <795>, <797>, <800> and <825>. Wyoming separately licenses 503B outsourcing facilities, which must label products 'For office use only' or 'Not for resale' (Ch. 8 §7(e)(iv)). This is consistent with FDA's view that 503A compounding is patient-specific.

Ch. 8 §4(s)(vii) and §4(w)(v), DSCSA-style definitions, exclude 'minimal quantities' distributed by a licensed retail pharmacy to a practitioner for office use from 'transaction' and 'wholesale distribution'. That exclusion concerns wholesale licensing and does not authorize compounded office stock. The former compounding chapters (Ch. 13 non-sterile, Ch. 17 sterile) are repealed. The Board has proposed technical fixes to Ch. 22's incorporation by reference (public comment closed).

Does the state require an FDA-registered 503B outsourcing facility located outside the state to hold a state license/registration (as an outsourcing facility, nonresident manufacturer, wholesaler or pharmacy) before shipping into the state?

Board Rules Ch. 8 §7 (eff. Aug. 19, 2025) require outsourcing facilities to be FDA-registered under 503B and state that resident and non-resident outsourcing facilities must be licensed as such in Wyoming and renew annually. They must meet all Ch. 8 wholesale-distributor requirements except VAWD accreditation. They must compound under a licensed pharmacist's direct supervision and follow cGMP, and supervising pharmacists must be certified through a Board-approved compounding certification program. Products must be labeled 'This is a compounded drug. For office use only' or 'Not for resale', bulk substances must meet FDA criteria, and the facility must send the Board copies of its twice-yearly FDA product reports. The Board's website says it does not yet have a separate outsourcing license type. In the meantime, a facility shipping to individuals in Wyoming may be licensed as a Non-Resident Pharmacy, and one shipping to facilities or pharmacies may be licensed as a Wholesale Distributor.

The rule calls for an outsourcing license 'as such', but the Board says that license type is still being created, so the interim credential is a Non-Resident Pharmacy or Wholesale Distributor license depending on customers; confirm with the Board (bop@wyo.gov). Only in-state outsourcing facilities are inspected by the Board (Ch. 8 §7(c)). Wyo. Stat. §33-24-153(a) requires a drug distributor's license for each location distributing prescription drugs in Wyoming, and nonresident distributors must also be licensed in their home state.

Has the state signed FDA's standard Memorandum of Understanding Addressing Certain Distributions of Compounded Human Drug Products (October 2020)? If not, FD&C Act §503A limits its 503A pharmacies' out-of-state distribution to 5% of total prescription orders (currently not enforced by FDA pending rulemaking).

Signing the standard MOU means the state board agrees to investigate complaints about compounded drugs its 503A pharmacies ship out of state and to identify and report to FDA pharmacies that distribute "inordinate amounts" interstate (more than 50% of their compounded prescriptions); in exchange, the statutory 5% out-of-state cap in FD&C Act §503A(b)(3)(B) does not apply to that state's pharmacies. FDA lists only Colorado, Kentucky and New Hampshire as signatories; Wyoming is not among them. For a non-signing state, FD&C Act §503A(b)(3)(B)(ii) caps a 503A pharmacy's out-of-state distribution of compounded drugs at 5% of its total prescription orders. FDA now considers the October 2020 standard MOU suspended (it does not expect signatory states to carry out MOU activities and will not sign new ones) and is not enforcing the 5% limit until a final rule and an updated MOU are published; FDA's rulemaking (RIN 0910-AI71) listed a proposed rule for 11/2026 in the Fall 2025 Unified Agenda.

The FDA list of signed MOUs (current as of 2023-01-23) is older than 2 years, but FDA stopped entering new agreements under the 2020 MOU in October 2022, so no state can have signed since. The FDA "Compounding Information for States" page (current as of 2026-08-28) still describes the MOU as awaiting rulemaking. Pending: FDA proposed rule on 503A distribution (RIN 0910-AI71, NPRM projected 11/2026); H.R. 5316 (introduced 2025-09-11, referred to House Energy & Commerce) would remove the MOU provision from §503A.

Besides DEA registration, does the state require practitioners to hold a separate state controlled substance registration, license or permit to prescribe, administer or dispense controlled substances (e.g. testosterone, Schedule III)? "Conditional" means a state registration is needed only in some settings, such as keeping controlled-substance stock in the office.

W.S. 35-7-1024(a) requires every person who dispenses any controlled substance in Wyoming to obtain every two years, on or before July 1, a registration issued by the State Board of Pharmacy; W.S. 35-7-1002 defines 'dispense' to include prescribing and administering. Failing to renew by July 1 incurs a late fee, and if not renewed by September 30 the registration is cancelled and DEA is notified to cancel the federal registration. A separate registration is required at each principal place of business or professional practice (35-7-1024(e)), and registered practitioners are enrolled in the Board's controlled substance prescription tracking program (35-7-1025(c)).

The Board of Pharmacy's application page and fee were not reviewed (fee set by Board rule under 35-7-1023). The order relative to DEA is not stated in the statute, but a lapsed state registration triggers DEA cancellation. Applies to all practitioners, including APRNs and PAs.

Must a prescriber query the state Prescription Drug Monitoring Program before prescribing, and does the mandate cover Schedule III drugs such as testosterone? "Yes" means a mandate that reaches Schedule III; "conditional" means a mandate limited to certain drugs (e.g. opioids or benzodiazepines) or situations; "no" means no prescriber query mandate.

Wyo. Stat. Sec. 35-7-1060(b) requires a practitioner (other than a veterinarian) or delegate prescribing a Schedule II, III, IV or V controlled substance to search the program for the patient's prior prescriptions before first issuing the prescription and thereafter as needed under best-practice guidelines for the profession; for opioids the search must be repeated every three months while opioids remain part of treatment, and Schedule V drugs require a search only if they are opioids. The Board of Pharmacy may grant time extensions and may by rule exempt certain inpatient settings, low-risk settings and emergencies, and it may audit practitioner usage and report low or inappropriate use to licensing boards. Dispensers must report Schedule II-V dispensing by the next business day.

Any Board of Pharmacy rule exemptions authorized by the statute were not opened. For testosterone the statutory duty is a search before the first prescription, then only 'as needed' under professional best practice.

May physicians dispense prescription drugs (not just administer them) directly to patients from their practice? "Yes" means allowed under standard rules (labeling, records, and at most a simple notice to the board); "conditional" means a separate dispensing registration, permit or license, or quantity, day-supply or drug-category limits; "no" means prohibited except narrow exceptions.

A vendor summary reports that Wyoming does not generally allow in-office physician dispensing, that no permit changes this, and that narrow exceptions exist for rural clinics without a nearby pharmacy. The statute and Board of Pharmacy rule text were not reviewed.

Only a vendor summary supports this answer; confirm with the Wyoming State Board of Pharmacy.

For a patient located in the state: must the prescriber hold this state's license (or a telehealth registration or special license), is an in-person exam required before prescribing (generally or for controlled substances), are there state limits on prescribing Schedule III drugs such as testosterone by telehealth, and is the state an Interstate Medical Licensure Compact member? "Yes" means a state license and the in-person standard of care apply (opioid-only or Schedule II-only limits are described but do not change the answer); "conditional" means extra state conditions such as a telehealth registration route, an in-person exam requirement, controlled-substance limits reaching Schedule III, or registration of telehealth businesses. Federal DEA rules apply on top.

(1) Any physician diagnosing or treating a person physically present in Wyoming must hold a Wyoming license regardless of location or means (Board of Medicine Rules ch. 1 sec. 4(e)); exemptions cover consultation with a Wyoming-licensed attending physician (with notice to the Board, up to 12 days per 52 weeks) and continued telehealth care for a Wyoming resident first seen in person in the physician's licensing state, for up to six months at a time between in-person encounters there (ch. 1 sec. 7). (2) No Wyoming rule requiring an in-person exam before telehealth prescribing by a Wyoming licensee was found. (3) The Board may discipline a physician for initially prescribing a controlled substance over the Internet absent a documented physician-patient relationship (W.S. 33-26-402(a)(xxxiii), per CCHP); no other Wyoming telehealth limit on Schedule III drugs such as testosterone was found. (4) IMLC: member.

Board of Medicine chapter 1 revised effective 2025-08-01 (after emergency amendments in 2023-2025). Chapter 3 (practice of medicine) has no telemedicine or controlled-substance telehealth section. W.S. 33-26-402 read via CCHP.

Who may administer botulinum toxin and dermal fillers (physicians, PAs, NPs, RNs, LPNs, estheticians, dentists), under what supervision (on-site vs available), and must a physician/NP/PA perform a prior good-faith exam?

The Wyoming State Board of Nursing's advisory opinion on aesthetic procedures and medical spas (approved 2008, last revised June 2025) says trained RNs may perform aesthetic procedures, including FDA-approved neuromodulator and filler injections, under the direction of a physician, PA or APRN who first performs a documented history and physical (face to face or telehealth) and writes a client-specific plan; any change to the plan needs a new provider assessment. The RN may follow written standing orders for each prescribed procedure, and the provider need not be on site but must be available in person or electronically. RNs may not choose the drug, dose, device or setting, recommend treatments or units, or compound. LPNs may perform some aesthetic procedures only with an on-site prescriber and may not perform injectable aesthetic procedures. A medical spa's medical director may be a physician, PA or APRN.

Revised June 2025 (month only). The Board posts its advisory opinions as Google Drive files linked from wsbn.wyo.gov/practice.

What does the state require for elective IV hydration/vitamin (incl. NAD+) therapy: who may start IVs, is a patient-specific order or good-faith exam required before a patient's first IV, are standing orders allowed, and are there rules for mobile IV services?

The Wyoming Boards of Medicine, Nursing and Pharmacy's Retail IV Therapy Collaborative Statement (covering wellness clinics, mobile hydration and drip bars) says only Wyoming-licensed physicians, PAs and APRNs may diagnose and prescribe. The physician/PA-patient relationship must be established with an audio/video interaction, not via form only. An RN may give IV fluids, nutrients, vitamins or medications only on a valid order that is part of a medically prescribed plan including a personal examination and bona fide relationship; RNs may not order fluids, set dose, route or frequency, recommend IVs or additives, or compound, and an RN owner/operator may not store medications. RNs must assess vital signs and monitor the patient; medications must be compounded and stored per the Pharmacy Act and USP <797>.

The statement carries no issue date (it cites 2023 sources); accessed 2026-09-23.

Does the state enforce the corporate practice of medicine doctrine (non-physicians may not own medical practices or employ physicians), and how does that affect med spa ownership?

Permit Health's 2025 guide lists Wyoming among non-CPOM states, citing Wyo. Stat. §§33-26-101, 17-3-101 to 104 and 17-21-1105; MedPath Compliance (reviewed 2026-06-20) also lists Wyoming as 'No'. The Board of Nursing's med spa opinion says a medical spa's medical director may be a physician, PA or APRN.

Who may perform laser/IPL/RF aesthetic procedures (laser hair removal, resurfacing): physicians only, delegated to RNs/PAs, or licensed electrologists/estheticians/laser technicians with state certification?

The Board of Nursing's 2025 aesthetic advisory opinion lists non-ablative light-based devices and 'laser for aesthetics or hair removal' among procedures a trained RN may perform under the direction of a physician, PA or APRN who has done a documented history and physical (face to face or telehealth) and set a client-specific plan, with the provider available in person or electronically. Selecting the device or device setting is outside RN scope. LPNs require an on-site prescriber who is immediately available. No Wyoming laser-technician licence or medical board laser rule was located.

Covers nurses only; delegation of lasers to unlicensed staff under Board of Medicine rules was not confirmed.

Does the state license clinical laboratories itself, beyond federal CLIA certification, including out-of-state labs that test specimens from the state?

Most states rely on federal CLIA certification alone. The states confirmed in this research as issuing their own lab licenses are California, New York, Pennsylvania, Maryland and Rhode Island (which also reach out-of-state labs testing specimens from their residents), plus Nevada, Washington, Massachusetts, New Jersey and New Hampshire (labs located in the state). Wyoming was not among them, but this research did not confirm its statutes. Wyoming's CLIA state agency is Wyoming Dept. of Health, Healthcare Licensing and Surveys (wdh-ohls@wyo.gov, 307-274-7524); it can confirm whether any state license or permit applies, including to out-of-state labs.

Absence of a state license was not verified against the state's statutes or rules.

May consumers order their own lab tests without a practitioner order (direct access testing)? A practitioner-ordered panel is always fine; this matters for take-home and consumer test kits.

ADLM (formerly AACC) reported in 2019 that 37 states and DC let consumers order some or all tests directly, but it did not publish the state list, and this research did not confirm Wyoming's rule. Wyoming's lab regulator (CLIA state agency) is Wyoming Dept. of Health, Healthcare Licensing and Surveys (wdh-ohls@wyo.gov, 307-274-7524). The question matters for take-home and consumer test kits, not for panels a clinician orders.

The ADLM figure dates from 2019 (older than 2 years).

Has the state enacted a law or rule specifically about stem cell, exosome or regenerative-medicine therapies (notice/disclosure duties, permission for certain non-FDA-approved uses, or Right to Try extensions covering them)?

Enrolled Act 31 (SF0048, 2026) created W.S. 35-4-1101 to 35-4-1106. It covers only autologous mesenchymal stem cells (collection, processing, culture expansion, manufacture, storage and therapeutic use), and nothing derived from an abortion. The conditions are: current IRB approval, or an investigational product that has completed Phase 1; cGMP manufacture and handling; an existing physician-patient relationship; physician registration with the Board of Medicine; and written consent covering FDA status, risks and the patient's financial responsibility. The physician administers the cells or directly supervises. The Board may not discipline registered physicians solely for recommending or performing the therapy, and it publishes a public registry of them. Physician assistants are excluded. Federal FDA rules still apply regardless of state law: stem cell, birth-tissue and exosome products are regulated by FDA, and a state law cannot make an unapproved biologic FDA-approved.

Autologous only: allogeneic birth-tissue products (amniotic, placental, Wharton's jelly) and exosomes are outside the Act. The governor's signature date was not on the enrolled text reviewed.

Does the state have cosmetic or sunscreen requirements beyond federal MoCRA, such as ingredient bans (PFAS, formaldehyde, phthalates), ingredient reporting, sunscreen-ingredient bans, or bans on selling animal-tested cosmetics?

Wyoming does not appear on 2026 compilations of state PFAS-in-cosmetics laws, on the list of states banning animal-tested cosmetics, or among the jurisdictions with sunscreen-ingredient bans. Federal MoCRA and FDA rules on cosmetics and OTC sunscreens still apply. Other state laws that touch cosmetics generally, such as state food-drug-cosmetic acts or consumer-protection laws, were not surveyed.

The animal-testing list is Wikipedia's 'as of 2023' compilation (older than 2 years); effective dates were not confirmed.