17D2123143 CLIA NUMBER - MARATHON HEALTH AT CARGILL-DODGE CITY

Laboratory Demographics

  • CLIA Code: 17D2123143
  • Facility Name: MARATHON HEALTH AT CARGILL-DODGE CITY
  • Facility Address: 2305 CENTRAL AVENUE
    DODGE CITY, KS
    ZIP 67801
  • Facility Phone: 802 857-0400
  • Facility Type: Other - ONSITE HEALTH CENTER
  • Facility Type: Waiver
  • Lab Director: JESSIE M. NIEDENS
  • NPI Number: 1295407062
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 17D2123143
LAB Type Other - ONSITE HEALTH CENTER
Facility Name MARATHON HEALTH AT CARGILL-DODGE CITY
Street 2305 CENTRAL AVENUE
City DODGE CITY
State KS
ZIP 67801
Phone 802 857-0400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/13/2024
Certificate Expiration Date 12/12/2026
Facility Type Other - ONSITE HEALTH CENTER
Lab Director JESSIE M. NIEDENS

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