26D2064678 CLIA NUMBER - WHITE OAK PSYCHIATRIC SERVICES

Home > CLIA Lookup > 26D2064678

Laboratory Demographics

CLIA Number: 26D2064678

Facility Name: WHITE OAK PSYCHIATRIC SERVICES

Facility Address:
4045 NE LAKEWOOD WAY, 130
LEES SUMMIT, MO
ZIP 64064
Get Directions

Facility Phone Number: 816 886-2184

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1376757617

Taxonomy: 103TP0016X - Psychologist
A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.

CLIA Record

Field Name	Field Value
CLIA Number	26D2064678
LAB Type	Physician Office
Facility Name	WHITE OAK PSYCHIATRIC SERVICES
Street	4045 NE LAKEWOOD WAY, 130
City	LEES SUMMIT
State	MO
ZIP	64064
Phone	816 886-2184
CertificateType	4
CertificateEffectiveDate	8/23/2023
CertificateExpirationDate	8/22/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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