26D0708630 CLIA NUMBER - SUMMIT PEDIATRICS, LLC

Laboratory Demographics

  • CLIA Code: 26D0708630
  • Facility Name: SUMMIT PEDIATRICS, LLC
  • Facility Address: 3171 NE CARNEGIE DRIVE, STE A
    LEES SUMMIT, MO
    ZIP 64064
  • Facility Phone: 816 525-2800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TAMARA L. PETERSON
  • NPI Number: 1700151818
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D0708630
LAB Type Physician Office
Facility Name SUMMIT PEDIATRICS, LLC
Street 3171 NE CARNEGIE DRIVE, STE A
City LEES SUMMIT
State MO
ZIP 64064
Phone 816 525-2800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director TAMARA L. PETERSON

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