17D2194249 CLIA NUMBER - GERIATRIC PRIMARY CARE, PA

Laboratory Demographics

  • CLIA Code: 17D2194249
  • Facility Name: GERIATRIC PRIMARY CARE, PA
  • Facility Address: 11111 NALL AVE, SUITE 103
    LEAWOOD, KS
    ZIP 66211
  • Facility Phone: 913 302-7183
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: MARK A. BATTIST
  • NPI Number: 1104672906
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 17D2194249
LAB Type Independent
Facility Name GERIATRIC PRIMARY CARE, PA
Street 11111 NALL AVE, SUITE 103
City LEAWOOD
State KS
ZIP 66211
Phone 913 302-7183
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type Independent
Lab Director MARK A. BATTIST

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