17D1012555 CLIA NUMBER - MARIANA E LUCERO, MD

Laboratory Demographics

  • CLIA Code: 17D1012555
  • Facility Name: MARIANA E LUCERO, MD
  • Facility Address: 2132 NORTH KANSAS AVE SUITE B
    LIBERAL, KS
    ZIP 67901
  • Facility Phone: 620 624-7400
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MARIANA E. LUCERO
  • NPI Number: 1831168673
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 17D1012555
LAB Type Practitioner Other
Facility Name MARIANA E LUCERO, MD
Street 2132 NORTH KANSAS AVE SUITE B
City LIBERAL
State KS
ZIP 67901
Phone 620 624-7400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Practitioner Other
Lab Director MARIANA E. LUCERO

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