17D0887927 CLIA NUMBER - STATLAND MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 17D0887927
  • Facility Name: STATLAND MEDICAL GROUP
  • Facility Address: 12140 NALL AVE, STE 100
    OVERLAND PARK, KS
    ZIP 66209
  • Facility Phone: 913 345-8500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL S. SOKOL
  • NPI Number: 1487679098
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 17D0887927
LAB Type Physician Office
Facility Name STATLAND MEDICAL GROUP
Street 12140 NALL AVE, STE 100
City OVERLAND PARK
State KS
ZIP 66209
Phone 913 345-8500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2024
Certificate Expiration Date 6/22/2026
Facility Type Physician Office
Lab Director MICHAEL S. SOKOL

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