29D0538339 CLIA NUMBER - INTERMOUNTAIN HEALTHCARE - WYNN

Laboratory Demographics

  • CLIA Code: 29D0538339
  • Facility Name: INTERMOUNTAIN HEALTHCARE - WYNN
  • Facility Address: 4880 WYNN RD
    LAS VEGAS, NV
    ZIP 89103
  • Facility Phone: 702 588-6972
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: WARREN J. FISHER
  • NPI Number: 1447344353
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 29D0538339
LAB Type Physician Office
Facility Name INTERMOUNTAIN HEALTHCARE - WYNN
Street 4880 WYNN RD
City LAS VEGAS
State NV
ZIP 89103
Phone 702 588-6972
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/7/2025
Certificate Expiration Date 3/6/2027
Facility Type Physician Office
Lab Director WARREN J. FISHER

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This page was last updated on: 6/4/2025