17D0450823 CLIA NUMBER - PARK VILLA

Laboratory Demographics

  • CLIA Code: 17D0450823
  • Facility Name: PARK VILLA
  • Facility Address: 114 S HIGH
    CLYDE, KS
    ZIP 66938
  • Facility Phone: 785 446-2818
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KELCEY GUY
  • NPI Number: 1629009337
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 17D0450823
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PARK VILLA
Street 114 S HIGH
City CLYDE
State KS
ZIP 66938
Phone 785 446-2818
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director KELCEY GUY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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