29D1029858 CLIA NUMBER - INTERMOUNTAIN HEALTHCARE - DURANGO PEDS

Laboratory Demographics

CLIA Number: 29D1029858

Facility Name: INTERMOUNTAIN HEALTHCARE - DURANGO PEDS

Facility Address:
5575 S DURANGO DR STE 103
LAS VEGAS, NV
ZIP 89113
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Facility Phone Number: 702 435-5437

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1043297468

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	29D1029858
LAB Type	Physician Office
Facility Name	INTERMOUNTAIN HEALTHCARE - DURANGO PEDS
Street	5575 S DURANGO DR STE 103
City	LAS VEGAS
State	NV
ZIP	89113
Phone	702 435-5437
CertificateType	4
CertificateEffectiveDate	8/24/2022
CertificateExpirationDate	8/23/2024
FacilityType	Waiver

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