26D2300605 CLIA NUMBER - KC SURGICENTER, LLC D/B/A BLUE RIVER SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 26D2300605
  • Facility Name: KC SURGICENTER, LLC D/B/A BLUE RIVER SURGERY CENTER
  • Facility Address: 1318 E 104TH STREET
    KANSAS CITY, MO
    ZIP 64131
  • Facility Phone: 816 256-5200
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: CAMERON TUSKEN
  • NPI Number: 1962277483
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2300605
LAB Type Ambulatory Surgery Center
Facility Name KC SURGICENTER, LLC D/B/A BLUE RIVER SURGERY CENTER
Street 1318 E 104TH STREET
City KANSAS CITY
State MO
ZIP 64131
Phone 816 256-5200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/13/2024
Certificate Expiration Date 3/12/2026
Facility Type Ambulatory Surgery Center
Lab Director CAMERON TUSKEN

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