17D2191990 CLIA NUMBER - DERBY ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 17D2191990
  • Facility Name: DERBY ASSISTED LIVING
  • Facility Address: 719 KLEIN CIRCLE
    DERBY, KS
    ZIP 67037
  • Facility Phone: 316 260-4447
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MIRANDA S. ROWLAND
  • NPI Number: 1396094470
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D2191990
LAB Type Assisted Living Facility
Facility Name DERBY ASSISTED LIVING
Street 719 KLEIN CIRCLE
City DERBY
State KS
ZIP 67037
Phone 316 260-4447
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2024
Certificate Expiration Date 9/2/2026
Facility Type Assisted Living Facility
Lab Director MIRANDA S. ROWLAND

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