17D0978758 CLIA NUMBER - VINTAGE PARK AT GARDNER

Laboratory Demographics

  • CLIA Code: 17D0978758
  • Facility Name: VINTAGE PARK AT GARDNER
  • Facility Address: 869 JUNIPER TERRACE ATTN EXECUTIVE DIRECTOR
    GARDNER, KS
    ZIP 66030
  • Facility Phone: 913 884-8900
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CALEB GAYLORD
  • NPI Number: 1548226475
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D0978758
LAB Type Assisted Living Facility
Facility Name VINTAGE PARK AT GARDNER
Street 869 JUNIPER TERRACE ATTN EXECUTIVE DIRECTOR
City GARDNER
State KS
ZIP 66030
Phone 913 884-8900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2024
Certificate Expiration Date 10/2/2026
Facility Type Assisted Living Facility
Lab Director CALEB GAYLORD

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