17D2058860 CLIA NUMBER - VISION SOURCE OF COLBY

Laboratory Demographics

  • CLIA Code: 17D2058860
  • Facility Name: VISION SOURCE OF COLBY
  • Facility Address: 1005 SOUTH RANGE AVENUE
    COLBY, KS
    ZIP 67701
  • Facility Phone: 785 462-8231
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MARY SHOAFF
  • NPI Number: 1609843390
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 17D2058860
LAB Type Practitioner Other
Facility Name VISION SOURCE OF COLBY
Street 1005 SOUTH RANGE AVENUE
City COLBY
State KS
ZIP 67701
Phone 785 462-8231
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Practitioner Other
Lab Director MARY SHOAFF

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