17D0453258 CLIA NUMBER - PARK LANE NURSING HOME

Laboratory Demographics

  • CLIA Code: 17D0453258
  • Facility Name: PARK LANE NURSING HOME
  • Facility Address: 210 E PARKLANE
    SCOTT CITY, KS
    ZIP 67871
  • Facility Phone: 620 872-5871
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHRISTIAN CUPP
  • NPI Number: 1417946187
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D0453258
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PARK LANE NURSING HOME
Street 210 E PARKLANE
City SCOTT CITY
State KS
ZIP 67871
Phone 620 872-5871
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 CHRISTIAN CUPP

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