29D1085105 CLIA NUMBER - LIFE CHANGE CENTER,THE

Laboratory Demographics

  • CLIA Code: 29D1085105
  • Facility Name: LIFE CHANGE CENTER,THE
  • Facility Address: 1755 SULLIVAN LN
    SPARKS, NV
    ZIP 89431
  • Facility Phone: 775 355-7734
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RYAN P. ZELLER
  • NPI Number: 1720611304
  • Taxonomy: 405300000X - Prevention Professional

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CLIA Record

Field Name Field Value
CLIA Number 29D1085105
LAB Type Physician Office
Facility Name LIFE CHANGE CENTER,THE
Street 1755 SULLIVAN LN
City SPARKS
State NV
ZIP 89431
Phone 775 355-7734
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2024
Certificate Expiration Date 6/9/2026
Facility Type Physician Office
Lab Director RYAN P. ZELLER

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