17D2109755 CLIA NUMBER - AIR CAPITAL DIALYSIS

Laboratory Demographics

  • CLIA Code: 17D2109755
  • Facility Name: AIR CAPITAL DIALYSIS
  • Facility Address: 1812 SOUTH SENECA STREET, SUITE 110
    WICHITA, KS
    ZIP 67213
  • Facility Phone: 316 263-1248
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RONNIE MOUSSA
  • NPI Number: 1881148948
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D2109755
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name AIR CAPITAL DIALYSIS
Street 1812 SOUTH SENECA STREET, SUITE 110
City WICHITA
State KS
ZIP 67213
Phone 316 263-1248
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RONNIE MOUSSA

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