17D0933656 CLIA NUMBER - STANTON COUNTY FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 17D0933656
  • Facility Name: STANTON COUNTY FAMILY PRACTICE
  • Facility Address: 404 NORTH CHESTNUT STREET
    JOHNSON, KS
    ZIP 67855
  • Facility Phone: 620 492-6250
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DOUGLAS JOHNSON
  • NPI Number: 1013978485
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 17D0933656
LAB Type Community Clinic
Facility Name STANTON COUNTY FAMILY PRACTICE
Street 404 NORTH CHESTNUT STREET
City JOHNSON
State KS
ZIP 67855
Phone 620 492-6250
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2025
Certificate Expiration Date 9/17/2027
Facility Type Community Clinic
Lab Director DOUGLAS JOHNSON

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