17D2099791 CLIA NUMBER - COLLEGE PARK FAMILY CARE - NEUROLOGY

Laboratory Demographics

  • CLIA Code: 17D2099791
  • Facility Name: COLLEGE PARK FAMILY CARE - NEUROLOGY
  • Facility Address: 10600 MASTIN, ENTRANCE C
    OVERLAND PARK, KS
    ZIP 66212
  • Facility Phone: 913 428-1415
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CANAAN K. COKER
  • NPI Number: 1609301324
  • Taxonomy: 225200000X - Physical Therapy Assistant

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CLIA Record

Field Name Field Value
CLIA Number 17D2099791
LAB Type Physician Office
Facility Name COLLEGE PARK FAMILY CARE - NEUROLOGY
Street 10600 MASTIN, ENTRANCE C
City OVERLAND PARK
State KS
ZIP 66212
Phone 913 428-1415
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2025
Certificate Expiration Date 8/2/2027
Facility Type Physician Office
Lab Director DR. CANAAN K. COKER

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