17D0448536 CLIA NUMBER - OSAWATOMIE STATE HOSPITAL PSYCHIATRIC

Laboratory Demographics

  • CLIA Code: 17D0448536
  • Facility Name: OSAWATOMIE STATE HOSPITAL PSYCHIATRIC
  • Facility Address: 500 STATE HOSPITAL DRIVE
    OSAWATOMIE, KS
    ZIP 66064
  • Facility Phone: 913 755-7000
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: MERMA A. GUSTILO
  • NPI Number: 1528040953
  • Taxonomy: 283Q00000X - Psychiatric Hospital

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CLIA Record

Field Name Field Value
CLIA Number 17D0448536
LAB Type Other
Facility Name OSAWATOMIE STATE HOSPITAL PSYCHIATRIC
Street 500 STATE HOSPITAL DRIVE
City OSAWATOMIE
State KS
ZIP 66064
Phone 913 755-7000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Other
Lab Director MERMA A. GUSTILO

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