17D0678971 CLIA NUMBER - IGNITE MEDICAL RESORT OVERLAND PARK, LLC

Laboratory Demographics

  • CLIA Code: 17D0678971
  • Facility Name: IGNITE MEDICAL RESORT OVERLAND PARK, LLC
  • Facility Address: 11901 ROSEWOOD DRIVE
    OVERLAND PARK, KS
    ZIP 66209
  • Facility Phone: 913 345-1745
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BRANDY M. CHUKU
  • NPI Number: 1972595080
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D0678971
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name IGNITE MEDICAL RESORT OVERLAND PARK, LLC
Street 11901 ROSEWOOD DRIVE
City OVERLAND PARK
State KS
ZIP 66209
Phone 913 345-1745
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 BRANDY M. CHUKU

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