17D2150055 CLIA NUMBER - MISSION CHATEAU

Laboratory Demographics

  • CLIA Code: 17D2150055
  • Facility Name: MISSION CHATEAU
  • Facility Address: 4100 WEST 85TH ST
    PRAIRIE VILLAGE, KS
    ZIP 66206
  • Facility Phone: 913 490-7100
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JOY E. CUEZZE
  • NPI Number: 1770067548
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D2150055
LAB Type Assisted Living Facility
Facility Name MISSION CHATEAU
Street 4100 WEST 85TH ST
City PRAIRIE VILLAGE
State KS
ZIP 66206
Phone 913 490-7100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Assisted Living Facility
Lab Director JOY E. CUEZZE

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