17D1051918 CLIA NUMBER - RUSSELL REGIONAL HOSPITAL PHYSICIAN'S CLINIC

Laboratory Demographics

  • CLIA Code: 17D1051918
  • Facility Name: RUSSELL REGIONAL HOSPITAL PHYSICIAN'S CLINIC
  • Facility Address: 200 S MAIN BLDG B
    RUSSELL, KS
    ZIP 67665
  • Facility Phone: 785 483-3333
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: TYREL SOMERS
  • NPI Number: 1215907951
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D1051918
LAB Type Rural Health Clinic
Facility Name RUSSELL REGIONAL HOSPITAL PHYSICIAN'S CLINIC
Street 200 S MAIN BLDG B
City RUSSELL
State KS
ZIP 67665
Phone 785 483-3333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2024
Certificate Expiration Date 3/13/2026
Facility Type Rural Health Clinic
Lab Director TYREL SOMERS

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