17D2159416 CLIA NUMBER - BOURBON COUNTY EMS

Laboratory Demographics

  • CLIA Code: 17D2159416
  • Facility Name: BOURBON COUNTY EMS
  • Facility Address: 405 WOODLANDHILLS BLVD
    FORT SCOTT, KS
    ZIP 66701
  • Facility Phone: (620) 223-2140
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: DAVID BRUNER
  • NPI Number: 1053880005
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 17D2159416
LAB Type Ambulance
Facility Name BOURBON COUNTY EMS
Street 405 WOODLANDHILLS BLVD
City FORT SCOTT
State KS
ZIP 66701
Phone 6202232140
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2024
Certificate Expiration Date 12/17/2026
Facility Type Ambulance
Lab Director DAVID BRUNER

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This page was last updated on: 5/18/2026