17D0449950 CLIA NUMBER - COMMUNITY PHYSICIANS CLINIC

Laboratory Demographics

CLIA Number: 17D0449950

Facility Name: COMMUNITY PHYSICIANS CLINIC

Facility Address:
1902 MAY
MARYSVILLE, KS
ZIP 66508
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Facility Phone Number: 785 562-3942

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1295749067

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	17D0449950
LAB Type	Physician Office
Facility Name	COMMUNITY PHYSICIANS CLINIC
Street	1902 MAY
City	MARYSVILLE
State	KS
ZIP	66508
Phone	785 562-3942
CertificateType	4
CertificateEffectiveDate	6/22/2022
CertificateExpirationDate	6/21/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024