17D2049344 CLIA NUMBER - HAVEN HOUSE

Laboratory Demographics

  • CLIA Code: 17D2049344
  • Facility Name: HAVEN HOUSE
  • Facility Address: 416 NORTH RENO AVENUE
    HAVEN, KS
    ZIP 67543
  • Facility Phone: 620 465-2421
  • Facility Type: Other - HOME PLUS FACILITY
  • Facility Type: Waiver
  • Lab Director: HEATHER HOLLE
  • NPI Number: 1528302577
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D2049344
LAB Type Other - HOME PLUS FACILITY
Facility Name HAVEN HOUSE
Street 416 NORTH RENO AVENUE
City HAVEN
State KS
ZIP 67543
Phone 620 465-2421
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Other - HOME PLUS FACILITY
Lab Director HEATHER HOLLE

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