17D2090294 CLIA NUMBER - CANTON AMBULANCE SERVICE

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Laboratory Demographics

CLIA Number: 17D2090294

Facility Name: CANTON AMBULANCE SERVICE

Facility Address:
201 SOUTH MAIN
CANTON, KS
ZIP 67428
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Facility Phone Number: 620 628-4666

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1437289428

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	17D2090294
LAB Type	Ambulance
Facility Name	CANTON AMBULANCE SERVICE
Street	201 SOUTH MAIN
City	CANTON
State	KS
ZIP	67428
Phone	620 628-4666
CertificateType	4
CertificateEffectiveDate	1/21/2023
CertificateExpirationDate	1/20/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024