29D0888242 CLIA NUMBER - CARSON TAHOE MEDICAL GROUP UROLOGY

Laboratory Demographics

  • CLIA Code: 29D0888242
  • Facility Name: CARSON TAHOE MEDICAL GROUP UROLOGY
  • Facility Address: 1425 VISTA LANE
    CARSON CITY, NV
    ZIP 89703
  • Facility Phone: 775 445-6680
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RANDALL NIXON
  • NPI Number: 1396822821
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 29D0888242
LAB Type Physician Office
Facility Name CARSON TAHOE MEDICAL GROUP UROLOGY
Street 1425 VISTA LANE
City CARSON CITY
State NV
ZIP 89703
Phone 775 445-6680
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2025
Certificate Expiration Date 7/27/2027
Facility Type Physician Office
Lab Director RANDALL NIXON

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This page was last updated on: 9/29/2025