17D1054503 CLIA NUMBER - WICHITA ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 17D1054503
  • Facility Name: WICHITA ENDOSCOPY CENTER
  • Facility Address: 9050 E 29TH ST N SUITE 100
    WICHITA, KS
    ZIP 67226
  • Facility Phone: 316 219-9651
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IMAD NASSIF, MD
  • NPI Number: 1245343912
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D1054503
LAB Type Physician Office
Facility Name WICHITA ENDOSCOPY CENTER
Street 9050 E 29TH ST N SUITE 100
City WICHITA
State KS
ZIP 67226
Phone 316 219-9651
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type Physician Office
Lab Director IMAD NASSIF, MD

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This page was last updated on: 6/4/2025