17D0674238 CLIA NUMBER - MID-KANSAS PEDIATRIC ASSOCIATES PA

Laboratory Demographics

  • CLIA Code: 17D0674238
  • Facility Name: MID-KANSAS PEDIATRIC ASSOCIATES PA
  • Facility Address: 9825 SHANNON WOODS
    WICHITA, KS
    ZIP 67226
  • Facility Phone: 316 634-2000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RACHEL STUCKY
  • NPI Number: 1629500020
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 17D0674238
LAB Type Physician Office
Facility Name MID-KANSAS PEDIATRIC ASSOCIATES PA
Street 9825 SHANNON WOODS
City WICHITA
State KS
ZIP 67226
Phone 316 634-2000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2024
Certificate Expiration Date 7/7/2026
Facility Type Physician Office
Lab Director RACHEL STUCKY

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