29D1001253 CLIA NUMBER - VALLEY PEDIATRIC & SPECIALTY CTR-W CHARLESTON

Laboratory Demographics

  • CLIA Code: 29D1001253
  • Facility Name: VALLEY PEDIATRIC & SPECIALTY CTR-W CHARLESTON
  • Facility Address: 3701 W CHARLESTON BLVD
    LAS VEGAS, NV
    ZIP 89102
  • Facility Phone: 702 388-4428
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TERESITA L. MELOCOTON
  • NPI Number: 1568892545
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 29D1001253
LAB Type Physician Office
Facility Name VALLEY PEDIATRIC & SPECIALTY CTR-W CHARLESTON
Street 3701 W CHARLESTON BLVD
City LAS VEGAS
State NV
ZIP 89102
Phone 702 388-4428
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2025
Certificate Expiration Date 2/12/2027
Facility Type Physician Office
Lab Director TERESITA L. MELOCOTON

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