17D2267082 CLIA NUMBER - RE NU MEDICAL & SPA

Laboratory Demographics

  • CLIA Code: 17D2267082
  • Facility Name: RE NU MEDICAL & SPA
  • Facility Address: 2425 BRADSHAW WAY
    PITTSBURG, KS
    ZIP 66762
  • Facility Phone: 620 308-6123
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACQUELINE M. YOUTSOS
  • NPI Number: 1881050995
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 17D2267082
LAB Type Physician Office
Facility Name RE NU MEDICAL & SPA
Street 2425 BRADSHAW WAY
City PITTSBURG
State KS
ZIP 66762
Phone 620 308-6123
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type Physician Office
Lab Director JACQUELINE M. YOUTSOS

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