17D0863612 CLIA NUMBER - FAMILY PRACTICE ASSOCIATES

Laboratory Demographics

  • CLIA Code: 17D0863612
  • Facility Name: FAMILY PRACTICE ASSOCIATES
  • Facility Address: 120 ROSS BLVD
    DODGE CITY, KS
    ZIP 67801
  • Facility Phone: 620 225-6120
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ROGER C. TROTTER M D
  • NPI Number: 1841255437
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D0863612
LAB Type Physician Office
Facility Name FAMILY PRACTICE ASSOCIATES
Street 120 ROSS BLVD
City DODGE CITY
State KS
ZIP 67801
Phone 620 225-6120
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director ROGER C. TROTTER M D

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This page was last updated on: 3/20/2025