17D2204749 CLIA NUMBER - ANDOVER DRUG

Laboratory Demographics

  • CLIA Code: 17D2204749
  • Facility Name: ANDOVER DRUG
  • Facility Address: 307 US HWY-54 STE 200
    WICHITA, KS
    ZIP 67002
  • Facility Phone: 316 260-6030
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DARED L. PRICE
  • NPI Number: 1578110540
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 17D2204749
LAB Type Pharmacy
Facility Name ANDOVER DRUG
Street 307 US HWY-54 STE 200
City WICHITA
State KS
ZIP 67002
Phone 316 260-6030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2024
Certificate Expiration Date 12/9/2026
Facility Type Pharmacy
Lab Director DARED L. PRICE

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