17D0448356 CLIA NUMBER - FREE STATE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 17D0448356
  • Facility Name: FREE STATE FAMILY MEDICINE
  • Facility Address: 1220 BILTMORE DRIVE
    LAWRENCE, KS
    ZIP 66049
  • Facility Phone: 785 505-2626
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAMELA J. HUERTER
  • NPI Number: 1831699826
  • Taxonomy: 133V00000X - Dietitian, Registered

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CLIA Record

Field Name Field Value
CLIA Number 17D0448356
LAB Type Physician Office
Facility Name FREE STATE FAMILY MEDICINE
Street 1220 BILTMORE DRIVE
City LAWRENCE
State KS
ZIP 66049
Phone 785 505-2626
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2025
Certificate Expiration Date 8/31/2027
Facility Type Physician Office
Lab Director PAMELA J. HUERTER

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This page was last updated on: 9/29/2025