CLIA lab
CLIA 17D2114616: Country Place Memory Care of Fort Scott
Fort Scott, KS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 17D2114616 belongs to Country Place Memory Care of Fort Scott in Fort Scott, KS.
Certificate of Waiver, effective June 17, 2026, expires June 16, 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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- June 17, 2026
- Certificate expiration
- June 16, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 17, 2016
- Facility type
- Assisted living facility
- Ownership (control type)
- Other
- 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
- 17D2114616
- Lab name
- Country Place Memory Care of Fort Scott
- Address
- 822 S Horton, Fort Scott, KS 66701
- Phone
- (620) 223-1822
- Fax
- (620) 224-1413
Annual test volume the lab reported
- Waived tests
- 10
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Fort Scott, KS
- Bourbon County EMSCertificate of Waiver, Ambulance17D2159416
- Community Health Center of Sek Fort ScottCertificate of Waiver, Federally qualified health center17D2165898
- Community Health Center of Southeast KansasCertificate of Waiver, Federally qualified health center17D2145179
- FT Scott Surgery Center LLCCertificate of Waiver, Ambulatory surgery center17D2014879
- Fort Scott CbocCertificate of Accreditation, Ambulatory surgery center17D1096274
- Fort Scott Family Medicine, PACertificate for Provider-Performed Microscopy Procedures, Physician office17D0986178
- Fort Scott Presbyterian VillageCertificate of Waiver, Assisted living facility17D0906649
- Freeman Fort Scott HospitalCertificate of Compliance, Hospital17D2328504
- Girard Medical Center of Fort ScottCertificate of Waiver, Rural health clinic17D2260418
- Kansas Renewal InstituteCertificate of Waiver, Other17D2303576
Related
Questions
What is the CLIA number for Country Place Memory Care of Fort Scott in Fort Scott?
17D2114616, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Country Place Memory Care of Fort Scott hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 17D2114616 expire?
The CMS file lists June 16, 2028 as the certificate expiration date; the certificate took effect June 17, 2026.