17D2144631 CLIA NUMBER - MAO LEAWOOD ASC, LLC

Laboratory Demographics

CLIA Number: 17D2144631

Facility Name: MAO LEAWOOD ASC, LLC

Facility Address:
4940 W 137TH ST, SUITE A
LEAWOOD, KS
ZIP 66224
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Facility Phone Number: 913 766-9014

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1689173981

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	17D2144631
LAB Type	Ambulatory Surgery Center
Facility Name	MAO LEAWOOD ASC, LLC
Street	4940 W 137TH ST, SUITE A
City	LEAWOOD
State	KS
ZIP	66224
Phone	913 766-9014
CertificateType	4
CertificateEffectiveDate	2/21/2024
CertificateExpirationDate	2/20/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024