17D0972227 CLIA NUMBER - ASBURY VILLAGE

Laboratory Demographics

  • CLIA Code: 17D0972227
  • Facility Name: ASBURY VILLAGE
  • Facility Address: 3800 ASBURY DR
    COFFEYVILLE, KS
    ZIP 67337
  • Facility Phone: 620 251-6270
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: AMANDA AUGUSTINE
  • NPI Number: 1235253642
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D0972227
LAB Type Other
Facility Name ASBURY VILLAGE
Street 3800 ASBURY DR
City COFFEYVILLE
State KS
ZIP 67337
Phone 620 251-6270
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2024
Certificate Expiration Date 4/2/2026
Facility Type Other
Lab Director AMANDA AUGUSTINE

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