26D2173947 CLIA NUMBER - BEACON SURGERY CENTER

Laboratory Demographics

CLIA Number: 26D2173947

Facility Name: BEACON SURGERY CENTER

Facility Address:
2861 NE INDEPENDENCE AVE, SUITE 101
LEES SUMMIT, MO
ZIP 64064
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Facility Phone Number: 832 271-1207

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1255991238

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D2173947
LAB Type	Ambulatory Surgery Center
Facility Name	BEACON SURGERY CENTER
Street	2861 NE INDEPENDENCE AVE, SUITE 101
City	LEES SUMMIT
State	MO
ZIP	64064
Phone	832 271-1207
CertificateType	4
CertificateEffectiveDate	10/22/2023
CertificateExpirationDate	10/21/2025
FacilityType	Waiver

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