29D1089540 CLIA NUMBER - BOX CANYON SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 29D1089540
  • Facility Name: BOX CANYON SURGERY CENTER LLC
  • Facility Address: 2555 BOX CANYON DR
    LAS VEGAS, NV
    ZIP 89128
  • Facility Phone: 702 733-2020
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KENT L. WELLISH MD
  • NPI Number: 1306093604
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 29D1089540
LAB Type Ambulatory Surgery Center
Facility Name BOX CANYON SURGERY CENTER LLC
Street 2555 BOX CANYON DR
City LAS VEGAS
State NV
ZIP 89128
Phone 702 733-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2024
Certificate Expiration Date 9/18/2026
Facility Type Ambulatory Surgery Center
Lab Director KENT L. WELLISH MD

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