17D2296673 CLIA NUMBER - COMMONSPIRIT WOMEN'S HEALTH - DODGE CITY

Laboratory Demographics

  • CLIA Code: 17D2296673
  • Facility Name: COMMONSPIRIT WOMEN'S HEALTH - DODGE CITY
  • Facility Address: 112 W ROSS BLVD, STE D
    DODGE CITY, KS
    ZIP 67801
  • Facility Phone: 620 371-7046
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAMIR SHAATH
  • NPI Number: 1639953219
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 17D2296673
LAB Type Physician Office
Facility Name COMMONSPIRIT WOMEN'S HEALTH - DODGE CITY
Street 112 W ROSS BLVD, STE D
City DODGE CITY
State KS
ZIP 67801
Phone 620 371-7046
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Physician Office
Lab Director SAMIR SHAATH

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