17D2217818 CLIA NUMBER - MILES MEDICAL GROUP, LLC

Laboratory Demographics

  • CLIA Code: 17D2217818
  • Facility Name: MILES MEDICAL GROUP, LLC
  • Facility Address: 11111 NALL AVENUE, SUITE 218
    LEAWOOD, KS
    ZIP 66211
  • Facility Phone: 913 261-9812
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHYNDA F. MILES
  • NPI Number: 1679718720
  • Taxonomy: 208100000X - Physical Medicine & Rehabilitation

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CLIA Record

Field Name Field Value
CLIA Number 17D2217818
LAB Type Physician Office
Facility Name MILES MEDICAL GROUP, LLC
Street 11111 NALL AVENUE, SUITE 218
City LEAWOOD
State KS
ZIP 66211
Phone 913 261-9812
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Physician Office
Lab Director SHYNDA F. MILES

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