17D1105979 CLIA NUMBER - BLUE VALLEY DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 17D1105979
  • Facility Name: BLUE VALLEY DERMATOLOGY
  • Facility Address: 7520 WEST 160TH STREET
    OVERLAND PARK, KS
    ZIP 66085
  • Facility Phone: 913 871-8221
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: LAUREN A. KYLE TKACHUK
  • NPI Number: 1942795976
  • Taxonomy: 1223P0221X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 17D1105979
LAB Type Physician Office
Facility Name BLUE VALLEY DERMATOLOGY
Street 7520 WEST 160TH STREET
City OVERLAND PARK
State KS
ZIP 66085
Phone 913 871-8221
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/28/2023
Certificate Expiration Date 12/27/2025
Facility Type Physician Office
Lab Director LAUREN A. KYLE TKACHUK

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