17D2205559 CLIA NUMBER - WHEAT HAVEN HOME LLC

Laboratory Demographics

  • CLIA Code: 17D2205559
  • Facility Name: WHEAT HAVEN HOME LLC
  • Facility Address: 304 MARION AVENUE
    MCDONALD, KS
    ZIP 67745
  • Facility Phone: 785 754-8223
  • Facility Type: Other - ADULT CARE HOME
  • Facility Type: Waiver
  • Lab Director: SHELLY WOOLF
  • NPI Number: 1396438958
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D2205559
LAB Type Other - ADULT CARE HOME
Facility Name WHEAT HAVEN HOME LLC
Street 304 MARION AVENUE
City MCDONALD
State KS
ZIP 67745
Phone 785 754-8223
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type Other - ADULT CARE HOME
Lab Director SHELLY WOOLF

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