17D0662765 CLIA NUMBER - WALLACE COUNTY FAMILY PRACTICE CLINIC

Laboratory Demographics

  • CLIA Code: 17D0662765
  • Facility Name: WALLACE COUNTY FAMILY PRACTICE CLINIC
  • Facility Address: 504 EAST 6TH STREET
    SHARON SPRINGS, KS
    ZIP 67758
  • Facility Phone: 785 852-4230
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: ELIZABETH WATKINS
  • NPI Number: 1477634301
  • Taxonomy: 261QP0905X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D0662765
LAB Type Rural Health Clinic
Facility Name WALLACE COUNTY FAMILY PRACTICE CLINIC
Street 504 EAST 6TH STREET
City SHARON SPRINGS
State KS
ZIP 67758
Phone 785 852-4230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2023
Certificate Expiration Date 9/30/2025
Facility Type Rural Health Clinic
Lab Director ELIZABETH WATKINS

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