17D0448588 CLIA NUMBER - AHMG PRIMARY CARE AT PAOLA

Laboratory Demographics

  • CLIA Code: 17D0448588
  • Facility Name: AHMG PRIMARY CARE AT PAOLA
  • Facility Address: 1401 BAPTISTE DRIVE, STE A
    PAOLA, KS
    ZIP 66071
  • Facility Phone: 913 294-2305
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNIFER C. BULCOCK

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CLIA Record

Field Name Field Value
CLIA Number 17D0448588
LAB Type Physician Office
Facility Name AHMG PRIMARY CARE AT PAOLA
Street 1401 BAPTISTE DRIVE, STE A
City PAOLA
State KS
ZIP 66071
Phone 913 294-2305
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2024
Certificate Expiration Date 1/23/2026
Facility Type Physician Office
Lab Director JENNIFER C. BULCOCK

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This page was last updated on: 6/4/2025