17D2170450 CLIA NUMBER - OURKANSAS GUARDIAN HOME HEALTH

Laboratory Demographics

  • CLIA Code: 17D2170450
  • Facility Name: OURKANSAS GUARDIAN HOME HEALTH
  • Facility Address: 9415 E HARRY ST, STE 605
    WICHITA, KS
    ZIP 67207
  • Facility Phone: 316 448-4250
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: JAMIE FOWLER
  • NPI Number: 1962977017
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 17D2170450
LAB Type Home Health Agency
Facility Name OURKANSAS GUARDIAN HOME HEALTH
Street 9415 E HARRY ST, STE 605
City WICHITA
State KS
ZIP 67207
Phone 316 448-4250
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type Home Health Agency
Lab Director JAMIE FOWLER

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