17D2127747 CLIA NUMBER - PLASTIC SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 17D2127747
  • Facility Name: PLASTIC SURGERY CENTER
  • Facility Address: 1861 N WEBB RD
    WICHITA, KS
    ZIP 67206
  • Facility Phone: 316 688-7500
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: AMY SPROLE
  • NPI Number: 1639253370
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 17D2127747
LAB Type Ambulatory Surgery Center
Facility Name PLASTIC SURGERY CENTER
Street 1861 N WEBB RD
City WICHITA
State KS
ZIP 67206
Phone 316 688-7500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type Ambulatory Surgery Center
Lab Director AMY SPROLE

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