17D1019111 CLIA NUMBER - FAMILY MEDICINE OF TONGANOXIE

Laboratory Demographics

  • CLIA Code: 17D1019111
  • Facility Name: FAMILY MEDICINE OF TONGANOXIE
  • Facility Address: 410 WOODFIELD DR
    TONGANOXIE, KS
    ZIP 66086
  • Facility Phone: 913 845-8400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM WEATHERFORD
  • NPI Number: 1255748471
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 17D1019111
LAB Type Physician Office
Facility Name FAMILY MEDICINE OF TONGANOXIE
Street 410 WOODFIELD DR
City TONGANOXIE
State KS
ZIP 66086
Phone 913 845-8400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Physician Office
Lab Director WILLIAM WEATHERFORD

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