17D1019997 CLIA NUMBER - KANSAS ENDOSCOPY

Laboratory Demographics

  • CLIA Code: 17D1019997
  • Facility Name: KANSAS ENDOSCOPY
  • Facility Address: 3121 NORTH WEBB ROAD SUITE 107
    WICHITA, KS
    ZIP 67226
  • Facility Phone: 316 219-2828
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BRYAN A. PENNER
  • NPI Number: 1538153887
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D1019997
LAB Type Ambulatory Surgery Center
Facility Name KANSAS ENDOSCOPY
Street 3121 NORTH WEBB ROAD SUITE 107
City WICHITA
State KS
ZIP 67226
Phone 316 219-2828
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/5/2023
Certificate Expiration Date 12/4/2025
Facility Type Ambulatory Surgery Center
Lab Director BRYAN A. PENNER

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