29D1043871 CLIA NUMBER - ANTHEM MEDICAL CENTER

Laboratory Demographics

CLIA Number: 29D1043871

Facility Name: ANTHEM MEDICAL CENTER

Facility Address:
660 S GREEN VALLEY PKWY STE 100
HENDERSON, NV
ZIP 89052
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Facility Phone Number: 702 731-9711

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1407043201

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	29D1043871
LAB Type	Physician Office
Facility Name	ANTHEM MEDICAL CENTER
Street	660 S GREEN VALLEY PKWY STE 100
City	HENDERSON
State	NV
ZIP	89052
Phone	702 731-9711
CertificateType	4
CertificateEffectiveDate	8/4/2023
CertificateExpirationDate	8/3/2025
FacilityType	Waiver

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