17D2015434 CLIA NUMBER - PREMIER OPEN MRI OF WICHITA

Laboratory Demographics

  • CLIA Code: 17D2015434
  • Facility Name: PREMIER OPEN MRI OF WICHITA
  • Facility Address: 500 S MAIN STREET
    WICHITA, KS
    ZIP 67202
  • Facility Phone: 316 262-1103
  • Facility Type: Other - DIAGNOSTIC IMAGING
  • Facility Type: Waiver
  • Lab Director: MITCHELL R. ENDRES
  • NPI Number: 1457343204
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D2015434
LAB Type Other - DIAGNOSTIC IMAGING
Facility Name PREMIER OPEN MRI OF WICHITA
Street 500 S MAIN STREET
City WICHITA
State KS
ZIP 67202
Phone 316 262-1103
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2024
Certificate Expiration Date 10/26/2026
Facility Type Other - DIAGNOSTIC IMAGING
Lab Director MITCHELL R. ENDRES

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