17D2193954 CLIA NUMBER - CEDAR LAKE VILLAGE

Laboratory Demographics

  • CLIA Code: 17D2193954
  • Facility Name: CEDAR LAKE VILLAGE
  • Facility Address: 15325 S. LONE ELM ROAD
    OLATHE, KS
    ZIP 66061
  • Facility Phone: 913 780-9916
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DEBORAH BECKWITH
  • NPI Number: 1255345427
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 17D2193954
LAB Type Assisted Living Facility
Facility Name CEDAR LAKE VILLAGE
Street 15325 S. LONE ELM ROAD
City OLATHE
State KS
ZIP 66061
Phone 913 780-9916
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2024
Certificate Expiration Date 9/24/2026
Facility Type Assisted Living Facility
Lab Director DEBORAH BECKWITH

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