17D2168421 CLIA NUMBER - QUEEN'S PRICE CHOPPER #4

Laboratory Demographics

  • CLIA Code: 17D2168421
  • Facility Name: QUEEN'S PRICE CHOPPER #4
  • Facility Address: 8686 ANTIOCH RD
    OVERLAND PARK, KS
    ZIP 66212
  • Facility Phone: 913 642-4140
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TONI L. SHIELDS
  • NPI Number: 1124193701
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2168421
LAB Type Pharmacy
Facility Name QUEEN'S PRICE CHOPPER #4
Street 8686 ANTIOCH RD
City OVERLAND PARK
State KS
ZIP 66212
Phone 913 642-4140
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2023
Certificate Expiration Date 6/27/2025
Facility Type Pharmacy
Lab Director TONI L. SHIELDS

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This page was last updated on: 3/20/2025