17D2270819 CLIA NUMBER - CANDLEWOOD HEALTHMART PHARMACY

Laboratory Demographics

  • CLIA Code: 17D2270819
  • Facility Name: CANDLEWOOD HEALTHMART PHARMACY
  • Facility Address: 3254 KIMBALL AVE
    MANHATTAN, KS
    ZIP 66503
  • Facility Phone: 785 776-4100
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY HELLERICH
  • NPI Number: 1770684557
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2270819
LAB Type Pharmacy
Facility Name CANDLEWOOD HEALTHMART PHARMACY
Street 3254 KIMBALL AVE
City MANHATTAN
State KS
ZIP 66503
Phone 785 776-4100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2024
Certificate Expiration Date 10/20/2026
Facility Type Pharmacy
Lab Director AMY HELLERICH

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