17D2288467 CLIA NUMBER - PEARL OBGYN

Laboratory Demographics

  • CLIA Code: 17D2288467
  • Facility Name: PEARL OBGYN
  • Facility Address: 3730 N RIDGE RD, SUITE 100A
    WICHITA, KS
    ZIP 67205
  • Facility Phone: 316 687-3275
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAMEN HERSHBERGER
  • NPI Number: 1659949931
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 17D2288467
LAB Type Physician Office
Facility Name PEARL OBGYN
Street 3730 N RIDGE RD, SUITE 100A
City WICHITA
State KS
ZIP 67205
Phone 316 687-3275
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2023
Certificate Expiration Date 8/24/2025
Facility Type Physician Office
Lab Director DAMEN HERSHBERGER

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This page was last updated on: 6/4/2025