17D0451264 CLIA NUMBER - WHEAT STATE MANOR INC

Laboratory Demographics

  • CLIA Code: 17D0451264
  • Facility Name: WHEAT STATE MANOR INC
  • Facility Address: 601 S MAIN
    WHITEWATER, KS
    ZIP 67154
  • Facility Phone: 316 799-2181
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JENNIFER SULLIVAN
  • NPI Number: 1780679498
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D0451264
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WHEAT STATE MANOR INC
Street 601 S MAIN
City WHITEWATER
State KS
ZIP 67154
Phone 316 799-2181
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 JENNIFER SULLIVAN

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This page was last updated on: 6/4/2025