29D0945588 CLIA NUMBER - LAKE MEAD PEDIATRICS

Laboratory Demographics

  • CLIA Code: 29D0945588
  • Facility Name: LAKE MEAD PEDIATRICS
  • Facility Address: 2031 MCDANIEL ST STE 220
    N LAS VEGAS, NV
    ZIP 89030
  • Facility Phone: 702 642-1409
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EMMANUEL V. TAGUBA MD
  • NPI Number: 1154367605
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 29D0945588
LAB Type Physician Office
Facility Name LAKE MEAD PEDIATRICS
Street 2031 MCDANIEL ST STE 220
City N LAS VEGAS
State NV
ZIP 89030
Phone 702 642-1409
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 Physician Office
Lab Director EMMANUEL V. TAGUBA MD

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