17D0448328 CLIA NUMBER - MEDICALODGE-LEAVENWORTH

Laboratory Demographics

  • CLIA Code: 17D0448328
  • Facility Name: MEDICALODGE-LEAVENWORTH
  • Facility Address: 1503 WEST OHIO
    LEAVENWORTH, KS
    ZIP 66048
  • Facility Phone: 913 772-1844
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LEA MICHELS RN BSN
  • NPI Number: 1942300215
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D0448328
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MEDICALODGE-LEAVENWORTH
Street 1503 WEST OHIO
City LEAVENWORTH
State KS
ZIP 66048
Phone 913 772-1844
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director LEA MICHELS RN BSN

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