17D2302233 CLIA NUMBER - RESOLUTE DERMATOLOGY LEAWOOD

Laboratory Demographics

  • CLIA Code: 17D2302233
  • Facility Name: RESOLUTE DERMATOLOGY LEAWOOD
  • Facility Address: 5405 151ST STREET
    LEAWOOD, KS
    ZIP 66224
  • Facility Phone: 913 901-5001
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DANIEL L. CHRISTIANSEN
  • NPI Number: 1124624028
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 17D2302233
LAB Type Physician Office
Facility Name RESOLUTE DERMATOLOGY LEAWOOD
Street 5405 151ST STREET
City LEAWOOD
State KS
ZIP 66224
Phone 913 901-5001
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/14/2025
Certificate Expiration Date 7/13/2027
Facility Type Physician Office
Lab Director DANIEL L. CHRISTIANSEN

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