17D2124499 CLIA NUMBER - COLLEGE PARK ENDOSCOPY CENTER, LLC DBA COLLEGE PARK SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 17D2124499
  • Facility Name: COLLEGE PARK ENDOSCOPY CENTER, LLC DBA COLLEGE PARK SURGERY CENTER
  • Facility Address: 10787 NALL AVENUE, SUITE 100
    OVERLAND PARK, KS
    ZIP 66211
  • Facility Phone: 913 652-9255
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ROBERT SCHUCHARDT
  • NPI Number: 1629510326
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D2124499
LAB Type Ambulatory Surgery Center
Facility Name COLLEGE PARK ENDOSCOPY CENTER, LLC DBA COLLEGE PARK SURGERY CENTER
Street 10787 NALL AVENUE, SUITE 100
City OVERLAND PARK
State KS
ZIP 66211
Phone 913 652-9255
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2025
Certificate Expiration Date 1/17/2027
Facility Type Ambulatory Surgery Center
Lab Director ROBERT SCHUCHARDT

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