17D0994063 CLIA NUMBER - MCLOUTH MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 17D0994063
  • Facility Name: MCLOUTH MEDICAL CLINIC
  • Facility Address: 313 S UNION STREET
    MC LOUTH, KS
    ZIP 66054
  • Facility Phone: 913 796-6116
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. WILLIAM WEATHERFORD
  • NPI Number: 1801077672
  • Taxonomy: 364SF0001X - Clinical Nurse Specialist

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CLIA Record

Field Name Field Value
CLIA Number 17D0994063
LAB Type Physician Office
Facility Name MCLOUTH MEDICAL CLINIC
Street 313 S UNION STREET
City MC LOUTH
State KS
ZIP 66054
Phone 913 796-6116
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Physician Office
Lab Director DR. WILLIAM WEATHERFORD

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