17D2243756 CLIA NUMBER - LEAVENWORTH USD #453

Laboratory Demographics

  • CLIA Code: 17D2243756
  • Facility Name: LEAVENWORTH USD #453
  • Facility Address: 570 EVERGREEN STREET
    LEAVENWORTH, KS
    ZIP 66048
  • Facility Phone: 913 684-1500
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: DANIELLE R. BAKER
  • NPI Number: 1922079441
  • Taxonomy: 261QM1200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D2243756
LAB Type School/Student Health Service
Facility Name LEAVENWORTH USD #453
Street 570 EVERGREEN STREET
City LEAVENWORTH
State KS
ZIP 66048
Phone 913 684-1500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/22/2023
Certificate Expiration Date 11/21/2025
Facility Type School/Student Health Service
Lab Director DANIELLE R. BAKER

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