17D2327446 CLIA NUMBER - MAIN STREET CLINIC

Laboratory Demographics

  • CLIA Code: 17D2327446
  • Facility Name: MAIN STREET CLINIC
  • Facility Address: 450 MORTON STREET
    ELKHART, KS
    ZIP 67950
  • Facility Phone: 620 518-3139
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HEIDY BRILLHART
  • NPI Number: 1841007739
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 17D2327446
LAB Type Physician Office
Facility Name MAIN STREET CLINIC
Street 450 MORTON STREET
City ELKHART
State KS
ZIP 67950
Phone 620 518-3139
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2025
Certificate Expiration Date 7/21/2027
Facility Type Physician Office
Lab Director HEIDY BRILLHART

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