17D1100665 CLIA NUMBER - DILLONS PHARMACY #34

Laboratory Demographics

  • CLIA Code: 17D1100665
  • Facility Name: DILLONS PHARMACY #34
  • Facility Address: 3932 WEST 13TH STREET
    WICHITA, KS
    ZIP 67203
  • Facility Phone: 316 942-7636
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT TOMASU
  • NPI Number: 1003084021
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D1100665
LAB Type Pharmacy
Facility Name DILLONS PHARMACY #34
Street 3932 WEST 13TH STREET
City WICHITA
State KS
ZIP 67203
Phone 316 942-7636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Pharmacy
Lab Director ROBERT TOMASU

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