17D1020727 CLIA NUMBER - VINTAGE PARK AT LENEXA

Laboratory Demographics

  • CLIA Code: 17D1020727
  • Facility Name: VINTAGE PARK AT LENEXA
  • Facility Address: 8710 CAENEN LAKE ROAD
    LENEXA, KS
    ZIP 66215
  • Facility Phone: 913 894-6979
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: LAKISHA WILLIAMS
  • NPI Number: 1356715569
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D1020727
LAB Type Assisted Living Facility
Facility Name VINTAGE PARK AT LENEXA
Street 8710 CAENEN LAKE ROAD
City LENEXA
State KS
ZIP 66215
Phone 913 894-6979
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2023
Certificate Expiration Date 12/29/2025
Facility Type Assisted Living Facility
Lab Director LAKISHA WILLIAMS

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This page was last updated on: 3/20/2025