17D0451032 CLIA NUMBER - MEDICALODGES GODDARD

Laboratory Demographics

  • CLIA Code: 17D0451032
  • Facility Name: MEDICALODGES GODDARD
  • Facility Address: 501 EASY STREET
    GODDARD, KS
    ZIP 67052
  • Facility Phone: 316 794-8635
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DANIELLE BRUMBELOW
  • NPI Number: 1386732998
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D0451032
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MEDICALODGES GODDARD
Street 501 EASY STREET
City GODDARD
State KS
ZIP 67052
Phone 316 794-8635
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 DANIELLE BRUMBELOW

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