17D1022711 CLIA NUMBER - FREE STATE DERMATOLOGY MATTHEW G BUXTON, MD, PA

Laboratory Demographics

  • CLIA Code: 17D1022711
  • Facility Name: FREE STATE DERMATOLOGY MATTHEW G BUXTON, MD, PA
  • Facility Address: 3511 CLINTON PLACE
    LAWRENCE, KS
    ZIP 66047
  • Facility Phone: 913 681-8914
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MATTHEW G. BUXTON, MD
  • NPI Number: 1730396680
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 17D1022711
LAB Type Physician Office
Facility Name FREE STATE DERMATOLOGY MATTHEW G BUXTON, MD, PA
Street 3511 CLINTON PLACE
City LAWRENCE
State KS
ZIP 66047
Phone 913 681-8914
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/24/2024
Certificate Expiration Date 2/23/2026
Facility Type Physician Office
Lab Director MATTHEW G. BUXTON, MD

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