29D0978926 CLIA NUMBER - CANYON TRAILS FAMILY PRACTICE & SPORTS MEDICINE

Laboratory Demographics

  • CLIA Code: 29D0978926
  • Facility Name: CANYON TRAILS FAMILY PRACTICE & SPORTS MEDICINE
  • Facility Address: 7455 W WASHINGTON AVE STE 445
    LAS VEGAS, NV
    ZIP 89128
  • Facility Phone: 702 804-5138
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL J. GUNTER MD
  • NPI Number: 1548398647
  • Taxonomy: 207QS0010X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 29D0978926
LAB Type Physician Office
Facility Name CANYON TRAILS FAMILY PRACTICE & SPORTS MEDICINE
Street 7455 W WASHINGTON AVE STE 445
City LAS VEGAS
State NV
ZIP 89128
Phone 702 804-5138
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2024
Certificate Expiration Date 10/5/2026
Facility Type Physician Office
Lab Director MICHAEL J. GUNTER MD

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