17D0994564 CLIA NUMBER - MARIA COURT

Laboratory Demographics

  • CLIA Code: 17D0994564
  • Facility Name: MARIA COURT
  • Facility Address: 633 E MAIN
    MULVANE, KS
    ZIP 67110
  • Facility Phone: 316 777-9917
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: BRENDA NICKEL
  • NPI Number: 1225161359
  • Taxonomy: 311Z00000X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D0994564
LAB Type Other
Facility Name MARIA COURT
Street 633 E MAIN
City MULVANE
State KS
ZIP 67110
Phone 316 777-9917
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Other
Lab Director BRENDA NICKEL

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