17D2203842 CLIA NUMBER - MIDWEST PEDIATRIC SPECIALIST PA

Laboratory Demographics

  • CLIA Code: 17D2203842
  • Facility Name: MIDWEST PEDIATRIC SPECIALIST PA
  • Facility Address: 10550 QUIVIRA RD, SUITE 520
    OVERLAND PARK, KS
    ZIP 66215
  • Facility Phone: 913 310-0482
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LARRY K. MIDYETT
  • NPI Number: 1891390548
  • Taxonomy: 2080P0206X - Pediatrics

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type Physician Office
Lab Director LARRY K. MIDYETT

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