17D1018056 CLIA NUMBER - DILLONS PHARMACY #066

Laboratory Demographics

  • CLIA Code: 17D1018056
  • Facility Name: DILLONS PHARMACY #066
  • Facility Address: 2244 NORTH ROCK ROAD CT
    WICHITA, KS
    ZIP 67220
  • Facility Phone: 316 685-5740
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT TOMASU
  • NPI Number: 1700826518
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D1018056
LAB Type Pharmacy
Facility Name DILLONS PHARMACY #066
Street 2244 NORTH ROCK ROAD CT
City WICHITA
State KS
ZIP 67220
Phone 316 685-5740
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2024
Certificate Expiration Date 4/10/2026
Facility Type Pharmacy
Lab Director ROBERT TOMASU

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