CLIA lab
CLIA 17D0891850: Prairie Mission Retirement Village
St Paul, KS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 17D0891850 belongs to Prairie Mission Retirement Village in St Paul, KS.
Certificate of Waiver, effective September 19, 2026, expires September 18, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 19, 2026
- Certificate expiration
- September 18, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 19, 1994
- Facility type
- Skilled nursing or nursing facility
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 17D0891850
- Lab name
- Prairie Mission Retirement Village
- Address
- 242 Carroll St, St Paul, KS 66771
- Phone
- (620) 449-2400
- Fax
- (620) 449-2404
Annual test volume the lab reported
- Waived tests
- 3,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Prairie Mission Retirement VillageCMS Care Compare ratings for the facility at the same street address
Other labs in St Paul, KS
Related
Questions
What is the CLIA number for Prairie Mission Retirement Village in St Paul?
17D0891850, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Prairie Mission Retirement Village hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 17D0891850 expire?
The CMS file lists September 18, 2028 as the certificate expiration date; the certificate took effect September 19, 2026.