29D1077083 CLIA NUMBER - SUNRISE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 29D1077083
  • Facility Name: SUNRISE PEDIATRICS
  • Facility Address: 3061 S MARYLAND PKWY STE 101
    LAS VEGAS, NV
    ZIP 89109
  • Facility Phone: 702 254-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SANJAY W. KANDOTH MD
  • NPI Number: 1558806570
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 29D1077083
LAB Type Physician Office
Facility Name SUNRISE PEDIATRICS
Street 3061 S MARYLAND PKWY STE 101
City LAS VEGAS
State NV
ZIP 89109
Phone 702 254-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2023
Certificate Expiration Date 11/29/2025
Facility Type Physician Office
Lab Director SANJAY W. KANDOTH MD

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