17D2204973 CLIA NUMBER - KEEPSAKE KOTTAGE MAIZE HOUSE

Laboratory Demographics

  • CLIA Code: 17D2204973
  • Facility Name: KEEPSAKE KOTTAGE MAIZE HOUSE
  • Facility Address: 1411 S MAIZE ROAD
    WICHITA, KS
    ZIP 67209
  • Facility Phone: 316 650-4526
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: KARI A. CAMERON
  • NPI Number: 1245652064
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D2204973
LAB Type Assisted Living Facility
Facility Name KEEPSAKE KOTTAGE MAIZE HOUSE
Street 1411 S MAIZE ROAD
City WICHITA
State KS
ZIP 67209
Phone 316 650-4526
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2024
Certificate Expiration Date 12/10/2026
Facility Type Assisted Living Facility
Lab Director KARI A. CAMERON

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