17D1076408 CLIA NUMBER - ADVANTAGE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 17D1076408
  • Facility Name: ADVANTAGE MEDICAL GROUP
  • Facility Address: 1104 EAST 23RD STREET
    LAWRENCE, KS
    ZIP 66046
  • Facility Phone: 785 749-0130
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DOUGLAS B. KNOX MD
  • NPI Number: 1922060128
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 17D1076408
LAB Type Physician Office
Facility Name ADVANTAGE MEDICAL GROUP
Street 1104 EAST 23RD STREET
City LAWRENCE
State KS
ZIP 66046
Phone 785 749-0130
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 11/14/2023
Certificate Expiration Date 11/13/2025
Facility Type Physician Office
Lab Director DOUGLAS B. KNOX MD

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