17D2301219 CLIA NUMBER - ELLSWORTH CORRECTIONAL FACILITY-EAST UNIT

Laboratory Demographics

  • CLIA Code: 17D2301219
  • Facility Name: ELLSWORTH CORRECTIONAL FACILITY-EAST UNIT
  • Facility Address: 1655 AVENUE K
    ELLSWORTH, KS
    ZIP 67439
  • Facility Phone: 785 227-9792
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: BRYAN WILSON
  • NPI Number: 1558364752
  • Taxonomy: 261QP0905X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D2301219
LAB Type Prison
Facility Name ELLSWORTH CORRECTIONAL FACILITY-EAST UNIT
Street 1655 AVENUE K
City ELLSWORTH
State KS
ZIP 67439
Phone 785 227-9792
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Prison
Lab Director BRYAN WILSON

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