17D2056134 CLIA NUMBER - MOBILE MEDICAL, LLC

Laboratory Demographics

  • CLIA Code: 17D2056134
  • Facility Name: MOBILE MEDICAL, LLC
  • Facility Address: 345 RIVERVIEW ST, S-500
    WICHITA, KS
    ZIP 67203
  • Facility Phone: (316) 992-7900
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: ANGIE KING
  • NPI Number: 1366727463
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 17D2056134
LAB Type Mobile Laboratory
Facility Name MOBILE MEDICAL, LLC
Street 345 RIVERVIEW ST, S-500
City WICHITA
State KS
ZIP 67203
Phone 3169927900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Mobile Laboratory
Lab Director ANGIE KING

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This page was last updated on: 5/18/2026