17D2137068 CLIA NUMBER - PINE RIDGE FAMILY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 17D2137068
  • Facility Name: PINE RIDGE FAMILY HEALTH CENTER
  • Facility Address: 2721 SE 10TH ST
    TOPEKA, KS
    ZIP 66607
  • Facility Phone: 785 783-8453
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNIFER R. HARADER
  • NPI Number: 1689192437
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 17D2137068
LAB Type Physician Office
Facility Name PINE RIDGE FAMILY HEALTH CENTER
Street 2721 SE 10TH ST
City TOPEKA
State KS
ZIP 66607
Phone 785 783-8453
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2025
Certificate Expiration Date 9/18/2027
Facility Type Physician Office
Lab Director JENNIFER R. HARADER

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