MEDICARE: LDW LABS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1689462970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LDW LABS LLC

Provider Business Mailing Address
First Line	:	1327 BURLINGTON ST STE K6
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64116-4068
Country	:	US
Telephone Number	:	816-643-0526
Fax Number	:	816-281-8144

Provider Business Practice Location Address
First Line	:	1327 BURLINGTON ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64116-4068
Country	:	US
Telephone Number	:	816-643-0526
Fax Number	:	816-281-8144

Authorized Official
Title or Position	:	LAB DIRECTOR
Name	:	LENASIA WILLIAMS
Credential	:
Telephone Number	:	816-768-4449

Provider Enumeration Date	:	04/28/2025
Last Update Date	:	08/26/2025

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