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17D2203842 CLIA NUMBER - MIDWEST PEDIATRIC SPECIALIST PA

Laboratory Demographics

CLIA Number: 17D2203842

Facility Name: MIDWEST PEDIATRIC SPECIALIST PA

Facility Address:
10550 QUIVIRA RD, SUITE 520
OVERLAND PARK, KS
ZIP 66215
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Facility Phone Number: 913 310-0482

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1891390548

Taxonomy: 2080P0205X - Pediatrics
A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands.

CLIA Record

Field Name Field Value
CLIA Number 17D2203842
LAB Type Physician Office
Facility Name MIDWEST PEDIATRIC SPECIALIST PA
Street 10550 QUIVIRA RD, SUITE 520
City OVERLAND PARK
State KS
ZIP 66215
Phone 913 310-0482
CertificateType 4
CertificateEffectiveDate 12/7/2022
CertificateExpirationDate 12/6/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024