17D2200017 CLIA NUMBER - LIVE ACTIVE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 17D2200017
  • Facility Name: LIVE ACTIVE PRIMARY CARE
  • Facility Address: 6650 W 110TH STREET, SUITE 220
    OVERLAND PARK, KS
    ZIP 66223
  • Facility Phone: (913) 549-3884
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HASEEB A. AHMED
  • NPI Number: 1245686625
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 17D2200017
LAB Type Physician Office
Facility Name LIVE ACTIVE PRIMARY CARE
Street 6650 W 110TH STREET, SUITE 220
City OVERLAND PARK
State KS
ZIP 66223
Phone 9135493884
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2024
Certificate Expiration Date 11/11/2026
Facility Type Physician Office
Lab Director HASEEB A. AHMED

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This page was last updated on: 5/18/2026