Healthcare Provider Details

I. General information

NPI: 1366156655
Provider Name (Legal Business Name): MOKAN LABS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14215 METCALF AVE
OVERLAND PARK KS
66223-3367
US

IV. Provider business mailing address

14215 METCALF AVE
OVERLAND PARK KS
66223-3367
US

V. Phone/Fax

Practice location:
  • Phone: 913-624-9005
  • Fax: 470-297-5495
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: AUSTIN WHILES
Title or Position: CEO, OWNER
Credential:
Phone: 470-649-4209