17D2182663 CLIA NUMBER - DERBY DRUG

Laboratory Demographics

  • CLIA Code: 17D2182663
  • Facility Name: DERBY DRUG
  • Facility Address: 1101 N ROCK RD #1
    DERBY, KS
    ZIP 67037
  • Facility Phone: 316 788-6669
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JONATHAN R. HANSEN
  • NPI Number: 1194828194
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 17D2182663
LAB Type Pharmacy
Facility Name DERBY DRUG
Street 1101 N ROCK RD #1
City DERBY
State KS
ZIP 67037
Phone 316 788-6669
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2025
Certificate Expiration Date 1/22/2027
Facility Type Pharmacy
Lab Director JONATHAN R. HANSEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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