17D0453236 CLIA NUMBER - MEADE RURAL HEALTH CLINIC

Laboratory Demographics

CLIA Number: 17D0453236

Facility Name: MEADE RURAL HEALTH CLINIC

Facility Address:
119 NORTH HART STREET
MEADE, KS
ZIP 67864
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Facility Phone Number: 620 873-2112

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1558367607

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	17D0453236
LAB Type	Physician Office
Facility Name	MEADE RURAL HEALTH CLINIC
Street	119 NORTH HART STREET
City	MEADE
State	KS
ZIP	67864
Phone	620 873-2112
CertificateType	4
CertificateEffectiveDate	10/29/2023
CertificateExpirationDate	10/28/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024