17D2205212 CLIA NUMBER - DOC SHOP, PA

Laboratory Demographics

  • CLIA Code: 17D2205212
  • Facility Name: DOC SHOP, PA
  • Facility Address: 5407 JOHNSON DRIVE
    MISSION, KS
    ZIP 66205
  • Facility Phone: 913 362-0220
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHARON LEE
  • NPI Number: 1275139305
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 17D2205212
LAB Type Physician Office
Facility Name DOC SHOP, PA
Street 5407 JOHNSON DRIVE
City MISSION
State KS
ZIP 66205
Phone 913 362-0220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Physician Office
Lab Director SHARON LEE

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