17D2150058 CLIA NUMBER - KELLY HOUSE TOPEKA #1

Laboratory Demographics

  • CLIA Code: 17D2150058
  • Facility Name: KELLY HOUSE TOPEKA #1
  • Facility Address: 2111 SW RANDOLPH AVENUE
    TOPEKA, KS
    ZIP 66611
  • Facility Phone: 785 228-7971
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CRYSTAL MCQUEEN
  • NPI Number: 1841626041
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D2150058
LAB Type Assisted Living Facility
Facility Name KELLY HOUSE TOPEKA #1
Street 2111 SW RANDOLPH AVENUE
City TOPEKA
State KS
ZIP 66611
Phone 785 228-7971
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Assisted Living Facility
Lab Director CRYSTAL MCQUEEN

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