17D2138439 CLIA NUMBER - STAFFORD COUNTY EMERGENCY SERVICE

Laboratory Demographics

  • CLIA Code: 17D2138439
  • Facility Name: STAFFORD COUNTY EMERGENCY SERVICE
  • Facility Address: 636 EAST 4TH AVENUE
    ST JOHN, KS
    ZIP 67576
  • Facility Phone: 620 549-3765
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MISTY M. BLAKESLEE
  • NPI Number: 1184215113
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2138439
LAB Type Ambulance
Facility Name STAFFORD COUNTY EMERGENCY SERVICE
Street 636 EAST 4TH AVENUE
City ST JOHN
State KS
ZIP 67576
Phone 620 549-3765
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type Ambulance
Lab Director MISTY M. BLAKESLEE

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