17D2294266 CLIA NUMBER - BEACON WEST SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 17D2294266
  • Facility Name: BEACON WEST SURGERY CENTER, LLC
  • Facility Address: 11340 NALL AVENUE, SUITE 100
    OVERLAND PARK, KS
    ZIP 66211
  • Facility Phone: (816) 786-4901
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MICHAEL DEMPEWOLF
  • NPI Number: 1598530578
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 17D2294266
LAB Type Ambulatory Surgery Center
Facility Name BEACON WEST SURGERY CENTER, LLC
Street 11340 NALL AVENUE, SUITE 100
City OVERLAND PARK
State KS
ZIP 66211
Phone 8167864901
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2025
Certificate Expiration Date 11/20/2027
Facility Type Ambulatory Surgery Center
Lab Director MICHAEL DEMPEWOLF

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This page was last updated on: 6/29/2026