17D2199937 CLIA NUMBER - LAKESIDE TERRACE

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CLIA Record

Field Name Field Value
CLIA Number 17D2199937
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name LAKESIDE TERRACE
Street 1100 HARRISON ST
City SABETHA
State KS
ZIP 66534
Phone 785 284-0005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2024
Certificate Expiration Date 11/11/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director DEBBIE TANGEMAN

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