17D0947647 CLIA NUMBER - HEALTHCORE CLINIC, INC

Laboratory Demographics

  • CLIA Code: 17D0947647
  • Facility Name: HEALTHCORE CLINIC, INC
  • Facility Address: 2707 E 21ST STREET
    WICHITA, KS
    ZIP 67214
  • Facility Phone: 316 691-0249
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: PENNY E. JEFFERY
  • NPI Number: 1033218565
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D0947647
LAB Type Federally Qualified Health Center
Facility Name HEALTHCORE CLINIC, INC
Street 2707 E 21ST STREET
City WICHITA
State KS
ZIP 67214
Phone 316 691-0249
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 6/22/2024
Certificate Expiration Date 6/21/2026
Facility Type Federally Qualified Health Center
Lab Director PENNY E. JEFFERY

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