17D2213130 CLIA NUMBER - COMMONSPIRIT FAMILY PRACTICE AND PEDIATRICS DODGE CITY

Laboratory Demographics

  • CLIA Code: 17D2213130
  • Facility Name: COMMONSPIRIT FAMILY PRACTICE AND PEDIATRICS DODGE CITY
  • Facility Address: 100 W ROSS BLVD, STE B
    DODGE CITY, KS
    ZIP 67801
  • Facility Phone: 620 371-5576
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MERRILL CONANT
  • NPI Number: 1023352374
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 17D2213130
LAB Type Physician Office
Facility Name COMMONSPIRIT FAMILY PRACTICE AND PEDIATRICS DODGE CITY
Street 100 W ROSS BLVD, STE B
City DODGE CITY
State KS
ZIP 67801
Phone 620 371-5576
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2025
Certificate Expiration Date 2/9/2027
Facility Type Physician Office
Lab Director MERRILL CONANT

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