17D2163913 CLIA NUMBER - INDIAN CREEK AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 17D2163913
  • Facility Name: INDIAN CREEK AMBULATORY SURGERY CENTER
  • Facility Address: 10720 NALL AVENUE, SUITES 100 & 200
    OVERLAND PARK, KS
    ZIP 66211
  • Facility Phone: 913 574-1900
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DOUGLAS LEMONS
  • NPI Number: 1932460177
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 17D2163913
LAB Type Ambulatory Surgery Center
Facility Name INDIAN CREEK AMBULATORY SURGERY CENTER
Street 10720 NALL AVENUE, SUITES 100 & 200
City OVERLAND PARK
State KS
ZIP 66211
Phone 913 574-1900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Ambulatory Surgery Center
Lab Director DOUGLAS LEMONS

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