17D0984932 CLIA NUMBER - INTERNAL MEDICINE SOUTH

Laboratory Demographics

  • CLIA Code: 17D0984932
  • Facility Name: INTERNAL MEDICINE SOUTH
  • Facility Address: 1431 S BLUFFVIEW, SUITE 111
    WICHITA, KS
    ZIP 67218
  • Facility Phone: 316 689-6490
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PATRICK G. WOLF, MD
  • NPI Number: 1194717694
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 17D0984932
LAB Type Physician Office
Facility Name INTERNAL MEDICINE SOUTH
Street 1431 S BLUFFVIEW, SUITE 111
City WICHITA
State KS
ZIP 67218
Phone 316 689-6490
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2025
Certificate Expiration Date 4/2/2027
Facility Type Physician Office
Lab Director PATRICK G. WOLF, MD

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