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29D0885979 CLIA NUMBER - INTERMOUNTAIN HEALTHCARE PARKWAY SUITE 210

Laboratory Demographics

CLIA Number: 29D0885979

Facility Name: INTERMOUNTAIN HEALTHCARE PARKWAY SUITE 210

Facility Address:
100 N GREEN VALLEY PKWY SUITE 210
HENDERSON, NV
ZIP 89074
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Facility Phone Number: 702 269-9995

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1508934977

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 29D0885979
LAB Type Physician Office
Facility Name INTERMOUNTAIN HEALTHCARE PARKWAY SUITE 210
Street 100 N GREEN VALLEY PKWY SUITE 210
City HENDERSON
State NV
ZIP 89074
Phone 702 269-9995
CertificateType 4
CertificateEffectiveDate 1/1/2024
CertificateExpirationDate 12/31/2025
FacilityType Waiver

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