17D0450778 CLIA NUMBER - WAVERLY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 17D0450778
  • Facility Name: WAVERLY MEDICAL CLINIC
  • Facility Address: 302 PEARSON AVENUE
    WAVERLY, KS
    ZIP 66871
  • Facility Phone: 620 364-2121
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: JOHN SHELL
  • NPI Number: 1578645628
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D0450778
LAB Type Rural Health Clinic
Facility Name WAVERLY MEDICAL CLINIC
Street 302 PEARSON AVENUE
City WAVERLY
State KS
ZIP 66871
Phone 620 364-2121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2024
Certificate Expiration Date 7/10/2026
Facility Type Rural Health Clinic
Lab Director JOHN SHELL

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