26D2095963 CLIA NUMBER - SHOAL CREEK DIALYSIS

Laboratory Demographics

  • CLIA Code: 26D2095963
  • Facility Name: SHOAL CREEK DIALYSIS
  • Facility Address: 8260 N BOOTH AVE
    KANSAS CITY, MO
    ZIP 64158
  • Facility Phone: 816 792-2502
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JUSTIN T. TEIWES
  • NPI Number: 1174900500
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2095963
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SHOAL CREEK DIALYSIS
Street 8260 N BOOTH AVE
City KANSAS CITY
State MO
ZIP 64158
Phone 816 792-2502
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JUSTIN T. TEIWES

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