17D0718679 CLIA NUMBER - WESTERN PRAIRIE SENIOR LIVING

Laboratory Demographics

  • CLIA Code: 17D0718679
  • Facility Name: WESTERN PRAIRIE SENIOR LIVING
  • Facility Address: 510 E SAN JACINTO AVENUE
    ULYSSES, KS
    ZIP 67880
  • Facility Phone: 785 228-7971
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: AERIAL FOUTCH
  • NPI Number: 1205358959
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D0718679
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WESTERN PRAIRIE SENIOR LIVING
Street 510 E SAN JACINTO AVENUE
City ULYSSES
State KS
ZIP 67880
Phone 785 228-7971
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 AERIAL FOUTCH

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