Organization
MOSAIC DIAGNOSTICS, LLC
Active
Other names
Great Plains Laboratory, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MICHEL MEYERS (DIRECTOR OF REGULATORY COMPLIANCE A)
(913) 341-8949
Entity
Organization
Contact information
Practice address
9221 QUIVIRA ROAD, OVERLAND PARK, KS 66215
(913) 341-8949
(913) 254-3331
Mailing address
8400 W 110TH STREET, SUITE 500, OVERLAND PARK, KS 66210
(913) 341-8949
(913) 254-3331
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
17D0919496
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17D0919496
CLIA NUMBER
—
Enumeration date
11/18/2005
Last updated
08/11/2023
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