17D2199964 CLIA NUMBER - ONH MEDICAL GROUP CHETOPA

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Laboratory Demographics

CLIA Number: 17D2199964

Facility Name: ONH MEDICAL GROUP CHETOPA

Facility Address:
429 MAPLE ST
CHETOPA, KS
ZIP 67336
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Facility Phone Number: 888 339-7339

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1083229488

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	17D2199964
LAB Type	Physician Office
Facility Name	ONH MEDICAL GROUP CHETOPA
Street	429 MAPLE ST
City	CHETOPA
State	KS
ZIP	67336
Phone	888 339-7339
CertificateType	4
CertificateEffectiveDate	11/12/2022
CertificateExpirationDate	11/11/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024