17D1087900 CLIA NUMBER - JOHNSON COUNTY IMAGING CENTER

Laboratory Demographics

  • CLIA Code: 17D1087900
  • Facility Name: JOHNSON COUNTY IMAGING CENTER
  • Facility Address: 11717 WEST 112TH STREET
    OVERLAND PARK, KS
    ZIP 66210
  • Facility Phone: 913 469-8998
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: RICHARD D. MILLER
  • NPI Number: 1720135114
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 17D1087900
LAB Type Ancillary Testing Site in Health Care Center
Facility Name JOHNSON COUNTY IMAGING CENTER
Street 11717 WEST 112TH STREET
City OVERLAND PARK
State KS
ZIP 66210
Phone 913 469-8998
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2024
Certificate Expiration Date 8/12/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director RICHARD D. MILLER

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