17D2050171 CLIA NUMBER - CRAIG HOMECARE, LLC DBA PEDIATRIC HOME SERVICE

Laboratory Demographics

  • CLIA Code: 17D2050171
  • Facility Name: CRAIG HOMECARE, LLC DBA PEDIATRIC HOME SERVICE
  • Facility Address: 2201 CENTRAL AVE, STE A
    DODGE CITY, KS
    ZIP 67801
  • Facility Phone: 651 642-1825
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ESMERALDA RUIZ
  • NPI Number: 1831599570
  • Taxonomy: 385H00000X - Respite Care

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CLIA Record

Field Name Field Value
CLIA Number 17D2050171
LAB Type Home Health Agency
Facility Name CRAIG HOMECARE, LLC DBA PEDIATRIC HOME SERVICE
Street 2201 CENTRAL AVE, STE A
City DODGE CITY
State KS
ZIP 67801
Phone 651 642-1825
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2024
Certificate Expiration Date 11/19/2026
Facility Type Home Health Agency
Lab Director ESMERALDA RUIZ

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