17D1002398 CLIA NUMBER - MERCY CLINIC FAMILY MEDICINE TUCKER TERRACE

Laboratory Demographics

  • CLIA Code: 17D1002398
  • Facility Name: MERCY CLINIC FAMILY MEDICINE TUCKER TERRACE
  • Facility Address: 2305 TUCKER TERRACE
    PITTSBURG, KS
    ZIP 66762
  • Facility Phone: 620 231-3132
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACQUELINE S. ORENDER
  • NPI Number: 1174559520
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 17D1002398
LAB Type Physician Office
Facility Name MERCY CLINIC FAMILY MEDICINE TUCKER TERRACE
Street 2305 TUCKER TERRACE
City PITTSBURG
State KS
ZIP 66762
Phone 620 231-3132
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2025
Certificate Expiration Date 4/30/2027
Facility Type Physician Office
Lab Director JACQUELINE S. ORENDER

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