17D1016673 CLIA NUMBER - COMPREHENSIVE WOMEN'S CARE

Laboratory Demographics

  • CLIA Code: 17D1016673
  • Facility Name: COMPREHENSIVE WOMEN'S CARE
  • Facility Address: 21624 MIDLAND DRIVE
    SHAWNEE, KS
    ZIP 66218
  • Facility Phone: 913 643-0075
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: GORDON B. CLARK, MD
  • NPI Number: 1790852135
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 17D1016673
LAB Type Physician Office
Facility Name COMPREHENSIVE WOMEN'S CARE
Street 21624 MIDLAND DRIVE
City SHAWNEE
State KS
ZIP 66218
Phone 913 643-0075
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Physician Office
Lab Director GORDON B. CLARK, MD

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