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29D1013766 CLIA NUMBER - INTERMOUNTAIN HEALTHCARE - BUFFALO

Laboratory Demographics

CLIA Number: 29D1013766

Facility Name: INTERMOUNTAIN HEALTHCARE - BUFFALO

Facility Address:
1700 N BUFFALO DR STE 100
LAS VEGAS, NV
ZIP 89128
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Facility Phone Number: 702 233-8855

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1902883341

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name Field Value
CLIA Number 29D1013766
LAB Type Physician Office
Facility Name INTERMOUNTAIN HEALTHCARE - BUFFALO
Street 1700 N BUFFALO DR STE 100
City LAS VEGAS
State NV
ZIP 89128
Phone 702 233-8855
CertificateType 4
CertificateEffectiveDate 6/17/2023
CertificateExpirationDate 6/16/2025
FacilityType Waiver

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