17D2253284 CLIA NUMBER - MARILLAC OUTPATIENT CLINIC

Laboratory Demographics

  • CLIA Code: 17D2253284
  • Facility Name: MARILLAC OUTPATIENT CLINIC
  • Facility Address: 8000 W 127TH ST
    OVERLAND PARK, KS
    ZIP 66213
  • Facility Phone: 913 574-3864
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NATHAN PRICHARD
  • NPI Number: 1790940591
  • Taxonomy: 261QM0855X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D2253284
LAB Type Physician Office
Facility Name MARILLAC OUTPATIENT CLINIC
Street 8000 W 127TH ST
City OVERLAND PARK
State KS
ZIP 66213
Phone 913 574-3864
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2024
Certificate Expiration Date 2/17/2026
Facility Type Physician Office
Lab Director NATHAN PRICHARD

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