17D2305550 CLIA NUMBER - MILFORD FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 17D2305550
  • Facility Name: MILFORD FAMILY PRACTICE
  • Facility Address: 103 SMITH STREET
    MILFORD, KS
    ZIP 66514
  • Facility Phone: 785 463-3333
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: SHANA C. ROETHER
  • NPI Number: 1831779289
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D2305550
LAB Type Rural Health Clinic
Facility Name MILFORD FAMILY PRACTICE
Street 103 SMITH STREET
City MILFORD
State KS
ZIP 66514
Phone 785 463-3333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Rural Health Clinic
Lab Director SHANA C. ROETHER

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