17D2154890 CLIA NUMBER - GRANT COUNTY DRUG

Laboratory Demographics

  • CLIA Code: 17D2154890
  • Facility Name: GRANT COUNTY DRUG
  • Facility Address: 219 N MAIN ST
    ULYSSES, KS
    ZIP 67880
  • Facility Phone: 620 356-1446
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TYSON MULLEN
  • NPI Number: 1063573178
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2154890
LAB Type Pharmacy
Facility Name GRANT COUNTY DRUG
Street 219 N MAIN ST
City ULYSSES
State KS
ZIP 67880
Phone 620 356-1446
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Pharmacy
Lab Director TYSON MULLEN

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