26D1008851 CLIA NUMBER - MIDWEST DIGESTIVE HEALTH CENTER LLC

Laboratory Demographics

CLIA Number: 26D1008851

Facility Name: MIDWEST DIGESTIVE HEALTH CENTER LLC

Facility Address:
3601 NE RALPH POWELL RD SUITE B
LEES SUMMIT, MO
ZIP 64064
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Facility Phone Number: 816 525-4440

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1558487009

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D1008851
LAB Type	Ambulatory Surgery Center
Facility Name	MIDWEST DIGESTIVE HEALTH CENTER LLC
Street	3601 NE RALPH POWELL RD SUITE B
City	LEES SUMMIT
State	MO
ZIP	64064
Phone	816 525-4440
CertificateType	4
CertificateEffectiveDate	1/29/2023
CertificateExpirationDate	1/28/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024