29D0881044 CLIA NUMBER - INTERMOUNTAIN HEALTHCARE - NELLIS

Laboratory Demographics

CLIA Number: 29D0881044

Facility Name: INTERMOUNTAIN HEALTHCARE - NELLIS

Facility Address:
821 N NELLIS BLVD STE 100
LAS VEGAS, NV
ZIP 89110
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Facility Phone Number: 702 438-4003

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1699092957

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name	Field Value
CLIA Number	29D0881044
LAB Type	Physician Office
Facility Name	INTERMOUNTAIN HEALTHCARE - NELLIS
Street	821 N NELLIS BLVD STE 100
City	LAS VEGAS
State	NV
ZIP	89110
Phone	702 438-4003
CertificateType	4
CertificateEffectiveDate	1/4/2024
CertificateExpirationDate	1/3/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024