29D0945586 CLIA NUMBER - LAKE TAHOE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 29D0945586
  • Facility Name: LAKE TAHOE SURGERY CENTER
  • Facility Address: 212 ELKS POINT RD STE 201
    ZEPHYR COVE, NV
    ZIP 89448
  • Facility Phone: 775 588-9188
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: TIGRAN AVAKUMOV
  • NPI Number: 1700963725
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 29D0945586
LAB Type Ambulatory Surgery Center
Facility Name LAKE TAHOE SURGERY CENTER
Street 212 ELKS POINT RD STE 201
City ZEPHYR COVE
State NV
ZIP 89448
Phone 775 588-9188
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2024
Certificate Expiration Date 5/4/2026
Facility Type Ambulatory Surgery Center
Lab Director TIGRAN AVAKUMOV

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