17D0451152 CLIA NUMBER - AXTELL CLINIC

Laboratory Demographics

  • CLIA Code: 17D0451152
  • Facility Name: AXTELL CLINIC
  • Facility Address: 700 MEDICAL CENTER DRIVE, SUITE 210
    NEWTON, KS
    ZIP 67114
  • Facility Phone: (316) 283-2800
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: RICHARD M. GLOVER MD
  • NPI Number: 1346286036
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 17D0451152
LAB Type Other
Facility Name AXTELL CLINIC
Street 700 MEDICAL CENTER DRIVE, SUITE 210
City NEWTON
State KS
ZIP 67114
Phone 3162832800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2026
Certificate Expiration Date 4/13/2028
Facility Type Other
Lab Director RICHARD M. GLOVER MD

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This page was last updated on: 5/18/2026