17D0449872 CLIA NUMBER - HEARTLAND DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 17D0449872
  • Facility Name: HEARTLAND DERMATOLOGY
  • Facility Address: 4201 ANDERSON AVE SUITE F
    MANHATTAN, KS
    ZIP 66503
  • Facility Phone: 785 628-3231
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JACE J. RICKSTREW
  • NPI Number: 1356588503
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D0449872
LAB Type Physician Office
Facility Name HEARTLAND DERMATOLOGY
Street 4201 ANDERSON AVE SUITE F
City MANHATTAN
State KS
ZIP 66503
Phone 785 628-3231
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 2/26/2024
Certificate Expiration Date 2/25/2026
Facility Type Physician Office
Lab Director JACE J. RICKSTREW

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