17D2097066 CLIA NUMBER - LABETTE HEALTH INDEPENDENCE CLINIC

Laboratory Demographics

  • CLIA Code: 17D2097066
  • Facility Name: LABETTE HEALTH INDEPENDENCE CLINIC
  • Facility Address: 510 N PETER PAN ROAD SUITE B
    INDEPENDENCE, KS
    ZIP 67301
  • Facility Phone: 620 577-4310
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: SKYLAR STACY
  • NPI Number: 1154787190
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D2097066
LAB Type Rural Health Clinic
Facility Name LABETTE HEALTH INDEPENDENCE CLINIC
Street 510 N PETER PAN ROAD SUITE B
City INDEPENDENCE
State KS
ZIP 67301
Phone 620 577-4310
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/4/2024
Certificate Expiration Date 3/3/2026
Facility Type Rural Health Clinic
Lab Director SKYLAR STACY

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