29D0926246 CLIA NUMBER - TONOPAH PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 29D0926246
  • Facility Name: TONOPAH PRIMARY CARE LLC
  • Facility Address: 119 ST PATRICK ST
    TONOPAH, NV
    ZIP 89049
  • Facility Phone: 775 482-9898
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ELJENA M. PETERSON
  • NPI Number: 1003305616
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 29D0926246
LAB Type Practitioner Other
Facility Name TONOPAH PRIMARY CARE LLC
Street 119 ST PATRICK ST
City TONOPAH
State NV
ZIP 89049
Phone 775 482-9898
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2025
Certificate Expiration Date 3/17/2027
Facility Type Practitioner Other
Lab Director ELJENA M. PETERSON

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