17D2154029 CLIA NUMBER - SCOTT CITY EYE CENTER

Laboratory Demographics

  • CLIA Code: 17D2154029
  • Facility Name: SCOTT CITY EYE CENTER
  • Facility Address: 104 ALBERT AVE
    SCOTT CITY, KS
    ZIP 67871
  • Facility Phone: 620 872-0040
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GOODEN J. JOSHUA
  • NPI Number: 1639277833
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 17D2154029
LAB Type Physician Office
Facility Name SCOTT CITY EYE CENTER
Street 104 ALBERT AVE
City SCOTT CITY
State KS
ZIP 67871
Phone 620 872-0040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2024
Certificate Expiration Date 9/4/2026
Facility Type Physician Office
Lab Director GOODEN J. JOSHUA

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