17D0978265 CLIA NUMBER - FAMILY HEALTH CENTER

Laboratory Demographics

CLIA Number: 17D0978265

Facility Name: FAMILY HEALTH CENTER

Facility Address:
521 MAIN
DEERFIELD, KS
ZIP 67838
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Facility Phone Number: 620 426-2990

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1114282563

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	17D0978265
LAB Type	Physician Office
Facility Name	FAMILY HEALTH CENTER
Street	521 MAIN
City	DEERFIELD
State	KS
ZIP	67838
Phone	620 426-2990
CertificateType	4
CertificateEffectiveDate	9/20/2022
CertificateExpirationDate	9/19/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024