29D0995963 CLIA NUMBER - CARELON HEALTH - GREEN VALLEY

Laboratory Demographics

CLIA Number: 29D0995963

Facility Name: CARELON HEALTH - GREEN VALLEY

Facility Address:
100 N GREEN VALLEY PKWY STE 220
HENDERSON, NV
ZIP 89074
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Facility Phone Number: 702 944-3627

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1528432507

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	29D0995963
LAB Type	Physician Office
Facility Name	CARELON HEALTH - GREEN VALLEY
Street	100 N GREEN VALLEY PKWY STE 220
City	HENDERSON
State	NV
ZIP	89074
Phone	702 944-3627
CertificateType	4
CertificateEffectiveDate	2/5/2024
CertificateExpirationDate	2/4/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024