17D0453296 CLIA NUMBER - COMMONSPIRIT PRIMARY CARE ULYSSES

Laboratory Demographics

  • CLIA Code: 17D0453296
  • Facility Name: COMMONSPIRIT PRIMARY CARE ULYSSES
  • Facility Address: 505 N MAIN ST
    ULYSSES, KS
    ZIP 67880
  • Facility Phone: 620 356-1261
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOUGLAS JOHNSON
  • NPI Number: 1497730071
  • Taxonomy: 261QR1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 17D0453296
LAB Type Physician Office
Facility Name COMMONSPIRIT PRIMARY CARE ULYSSES
Street 505 N MAIN ST
City ULYSSES
State KS
ZIP 67880
Phone 620 356-1261
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 Physician Office
Lab Director DOUGLAS JOHNSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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