29D1050891 CLIA NUMBER - CAESARS LAKE TAHOE HEALTH AND WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 29D1050891
  • Facility Name: CAESARS LAKE TAHOE HEALTH AND WELLNESS CENTER
  • Facility Address: 15 HWY 50
    STATELINE, NV
    ZIP 89449
  • Facility Phone: 775 586-5000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GREGORY E. YAGER
  • NPI Number: 1306333604
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 29D1050891
LAB Type Physician Office
Facility Name CAESARS LAKE TAHOE HEALTH AND WELLNESS CENTER
Street 15 HWY 50
City STATELINE
State NV
ZIP 89449
Phone 775 586-5000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Physician Office
Lab Director GREGORY E. YAGER

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This page was last updated on: 6/4/2025