17D0452733 CLIA NUMBER - MEDICALODGES GREAT BEND

Laboratory Demographics

  • CLIA Code: 17D0452733
  • Facility Name: MEDICALODGES GREAT BEND
  • Facility Address: 1401 CHERRY LANE
    GREAT BEND, KS
    ZIP 67530
  • Facility Phone: 620 792-2165
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SHANNON LAGER
  • NPI Number: 1720561541
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D0452733
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MEDICALODGES GREAT BEND
Street 1401 CHERRY LANE
City GREAT BEND
State KS
ZIP 67530
Phone 620 792-2165
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 SHANNON LAGER

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