17D1013610 CLIA NUMBER - PARK WEST PLAZA

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CLIA Record

Field Name Field Value
CLIA Number 17D1013610
LAB Type Physician Office
Facility Name PARK WEST PLAZA
Street 505 N MAIZE RD ATTN KIRA ROBINSON
City WICHITA
State KS
ZIP 67212
Phone 3167294114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2025
Certificate Expiration Date 6/11/2027
Facility Type Physician Office
Lab Director KELLY THOMAS

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This page was last updated on: 6/29/2026