17D0886466 CLIA NUMBER - EVERGREEN COMMUNITY OF JOHNSON COUNTY

Laboratory Demographics

  • CLIA Code: 17D0886466
  • Facility Name: EVERGREEN COMMUNITY OF JOHNSON COUNTY
  • Facility Address: 11875 S SUNSET DRIVE, SUITE 100
    OLATHE, KS
    ZIP 66061
  • Facility Phone: 913 477-8235
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DULKU RAMANDEEP
  • NPI Number: 1356749527
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 17D0886466
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EVERGREEN COMMUNITY OF JOHNSON COUNTY
Street 11875 S SUNSET DRIVE, SUITE 100
City OLATHE
State KS
ZIP 66061
Phone 913 477-8235
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2024
Certificate Expiration Date 5/18/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DULKU RAMANDEEP

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