17D0890191 CLIA NUMBER - MONTEZUMA RURAL HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 17D0890191
  • Facility Name: MONTEZUMA RURAL HEALTH CLINIC
  • Facility Address: 304 N AZTEC STREET
    MONTEZUMA, KS
    ZIP 67867
  • Facility Phone: 620 846-2251
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: ANDREW W. SCHOWENGERDT
  • NPI Number: 1720609738
  • Taxonomy: 261QR1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 17D0890191
LAB Type Rural Health Clinic
Facility Name MONTEZUMA RURAL HEALTH CLINIC
Street 304 N AZTEC STREET
City MONTEZUMA
State KS
ZIP 67867
Phone 620 846-2251
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 8/15/2024
Certificate Expiration Date 8/14/2026
Facility Type Rural Health Clinic
Lab Director ANDREW W. SCHOWENGERDT

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