17D0453114 CLIA NUMBER - COMMONSPIRIT INTERNAL MEDICINE DODGE CITY

Laboratory Demographics

  • CLIA Code: 17D0453114
  • Facility Name: COMMONSPIRIT INTERNAL MEDICINE DODGE CITY
  • Facility Address: 112 W ROSS BLVD, STE A
    DODGE CITY, KS
    ZIP 67801
  • Facility Phone: 620 227-1371
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MAHMUD MAJEED
  • NPI Number: 1689699613
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 17D0453114
LAB Type Physician Office
Facility Name COMMONSPIRIT INTERNAL MEDICINE DODGE CITY
Street 112 W ROSS BLVD, STE A
City DODGE CITY
State KS
ZIP 67801
Phone 620 227-1371
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Physician Office
Lab Director MAHMUD MAJEED

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