17D2310393 CLIA NUMBER - JCMHC CHRONIC CARE CLINIC

Laboratory Demographics

  • CLIA Code: 17D2310393
  • Facility Name: JCMHC CHRONIC CARE CLINIC
  • Facility Address: 6440 NIEMAN ROAD, ROOMS 7B, 7C, AND 10
    SHAWNEE, KS
    ZIP 66203
  • Facility Phone: 913 826-4200
  • Facility Type: Other - CHRONIC CARE FOR JCMHC
  • Facility Type: Waiver
  • Lab Director: ANDY TROUT
  • NPI Number: 1548989262
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 17D2310393
LAB Type Other - CHRONIC CARE FOR JCMHC
Facility Name JCMHC CHRONIC CARE CLINIC
Street 6440 NIEMAN ROAD, ROOMS 7B, 7C, AND 10
City SHAWNEE
State KS
ZIP 66203
Phone 913 826-4200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2024
Certificate Expiration Date 9/2/2026
Facility Type Other - CHRONIC CARE FOR JCMHC
Lab Director ANDY TROUT

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