17D0969645 CLIA NUMBER - EAGLE ESTATES

Laboratory Demographics

  • CLIA Code: 17D0969645
  • Facility Name: EAGLE ESTATES
  • Facility Address: 1354 TAYLOR ROAD
    INDEPENDENCE, KS
    ZIP 67301
  • Facility Phone: (620) 331-1662
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JENNIFER R. TUCKER
  • NPI Number: 1184757098
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D0969645
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EAGLE ESTATES
Street 1354 TAYLOR ROAD
City INDEPENDENCE
State KS
ZIP 67301
Phone 6203311662
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2026
Certificate Expiration Date 1/20/2028
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JENNIFER R. TUCKER

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This page was last updated on: 5/18/2026