17D0917858 CLIA NUMBER - CORNERSTONE BROADMOOR

Laboratory Demographics

  • CLIA Code: 17D0917858
  • Facility Name: CORNERSTONE BROADMOOR
  • Facility Address: 1240 N BROADMOOR AVE
    WICHITA, KS
    ZIP 67206
  • Facility Phone: 316 636-5101
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: NAKISHA WEBSTER
  • NPI Number: 1508911074
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D0917858
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CORNERSTONE BROADMOOR
Street 1240 N BROADMOOR AVE
City WICHITA
State KS
ZIP 67206
Phone 316 636-5101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director NAKISHA WEBSTER

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