17D2238346 CLIA NUMBER - PARADISE ROOTS PHARMACY, INC

Laboratory Demographics

  • CLIA Code: 17D2238346
  • Facility Name: PARADISE ROOTS PHARMACY, INC
  • Facility Address: 101 E MAIN ST
    HILL CITY, KS
    ZIP 67642
  • Facility Phone: 785 421-5632
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KYLEE SHAE
  • NPI Number: 1285275602
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2238346
LAB Type Pharmacy
Facility Name PARADISE ROOTS PHARMACY, INC
Street 101 E MAIN ST
City HILL CITY
State KS
ZIP 67642
Phone 785 421-5632
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2023
Certificate Expiration Date 10/3/2025
Facility Type Pharmacy
Lab Director KYLEE SHAE

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