CLIA lab
CLIA 17D2105480: Rolla Medical Clinic
Rolla, KS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 17D2105480 belongs to Rolla Medical Clinic in Rolla, KS.
Certificate of Waiver, effective November 25, 2025, expires November 24, 2027.
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
- November 25, 2025
- Certificate expiration
- November 24, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 25, 2015
- Facility type
- Rural health clinic
- Ownership (control type)
- Government, county
- 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
- 17D2105480
- Lab name
- Rolla Medical Clinic
- Address
- 415 Washington, Rolla, KS 67954
- Phone
- (620) 697-2141
- Fax
- (620) 741-8186
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Related
Questions
What is the CLIA number for Rolla Medical Clinic in Rolla?
17D2105480, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Rolla Medical Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 17D2105480 expire?
The CMS file lists November 24, 2027 as the certificate expiration date; the certificate took effect November 25, 2025.