17D2125097 CLIA NUMBER - HEN HOUSE PHARMACY #35

Laboratory Demographics

  • CLIA Code: 17D2125097
  • Facility Name: HEN HOUSE PHARMACY #35
  • Facility Address: 2724 W 53RD ST
    FAIRWAY, KS
    ZIP 66205
  • Facility Phone: 913 236-4983
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL HALLWELL
  • NPI Number: 1396851762
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2125097
LAB Type Pharmacy
Facility Name HEN HOUSE PHARMACY #35
Street 2724 W 53RD ST
City FAIRWAY
State KS
ZIP 66205
Phone 913 236-4983
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2025
Certificate Expiration Date 1/30/2027
Facility Type Pharmacy
Lab Director MICHAEL HALLWELL

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