29D1088241 CLIA NUMBER - JATEKO FAMILY MEDICAL GROUP JEANIENE A TALLEY A PROFESSIONAL CORP

Laboratory Demographics

CLIA Number: 29D1088241

Facility Name: JATEKO FAMILY MEDICAL GROUP JEANIENE A TALLEY A PROFESSIONAL CORP

Facility Address:
3860 W ANN RD STE 100
NORTH LAS VEGAS, NV
ZIP 89031
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Facility Phone Number: 702 474-4110

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1356528103

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	29D1088241
LAB Type	Physician Office
Facility Name	JATEKO FAMILY MEDICAL GROUP JEANIENE A TALLEY A PROFESSIONAL CORP
Street	3860 W ANN RD STE 100
City	NORTH LAS VEGAS
State	NV
ZIP	89031
Phone	702 474-4110
CertificateType	4
CertificateEffectiveDate	8/20/2022
CertificateExpirationDate	8/19/2024
FacilityType	Waiver

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