17D1006004 CLIA NUMBER - BRYAN K DENNETT MD PA

Laboratory Demographics

  • CLIA Code: 17D1006004
  • Facility Name: BRYAN K DENNETT MD PA
  • Facility Address: 1305 E 19TH AVENUE
    WINFIELD, KS
    ZIP 67156
  • Facility Phone: 620 221-9500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRYAN K. DENNETT
  • NPI Number: 1770697526
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 17D1006004
LAB Type Physician Office
Facility Name BRYAN K DENNETT MD PA
Street 1305 E 19TH AVENUE
City WINFIELD
State KS
ZIP 67156
Phone 620 221-9500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Physician Office
Lab Director BRYAN K. DENNETT

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