17D0976715 CLIA NUMBER - PHILLIPS CO EMERGENCY MEDICAL SERVICE

Laboratory Demographics

  • CLIA Code: 17D0976715
  • Facility Name: PHILLIPS CO EMERGENCY MEDICAL SERVICE
  • Facility Address: 409 E STREET
    PHILLIPSBURG, KS
    ZIP 67661
  • Facility Phone: 785 543-6805
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MARY J. HOLLE
  • NPI Number: 1376055699
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 17D0976715
LAB Type Ambulance
Facility Name PHILLIPS CO EMERGENCY MEDICAL SERVICE
Street 409 E STREET
City PHILLIPSBURG
State KS
ZIP 67661
Phone 785 543-6805
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2024
Certificate Expiration Date 8/10/2026
Facility Type Ambulance
Lab Director MARY J. HOLLE

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This page was last updated on: 3/20/2025