17D2208374 CLIA NUMBER - MIDWEST PSYCHIATRIC SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 17D2208374
  • Facility Name: MIDWEST PSYCHIATRIC SERVICES, LLC
  • Facility Address: 2554 N PARADISE CT
    WICHITA, KS
    ZIP 67205
  • Facility Phone: 316 833-1259
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ANGELA D. KING
  • NPI Number: 1134758683
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D2208374
LAB Type Practitioner Other
Facility Name MIDWEST PSYCHIATRIC SERVICES, LLC
Street 2554 N PARADISE CT
City WICHITA
State KS
ZIP 67205
Phone 316 833-1259
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2025
Certificate Expiration Date 1/5/2027
Facility Type Practitioner Other
Lab Director ANGELA D. KING

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