29D1097817 CLIA NUMBER - CENTENNIAL MEDICAL GROUP LLP-N DECATUR

Laboratory Demographics

CLIA Number: 29D1097817

Facility Name: CENTENNIAL MEDICAL GROUP LLP-N DECATUR

Facility Address:
4454 N DECATUR BLVD
LAS VEGAS, NV
ZIP 89130
Get Directions

Facility Phone Number: 702 839-1203

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1730375015

Taxonomy: 207LP2900X - Anesthesiology
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

CLIA Record

Field Name	Field Value
CLIA Number	29D1097817
LAB Type	Physician Office
Facility Name	CENTENNIAL MEDICAL GROUP LLP-N DECATUR
Street	4454 N DECATUR BLVD
City	LAS VEGAS
State	NV
ZIP	89130
Phone	702 839-1203
CertificateType	4
CertificateEffectiveDate	4/3/2023
CertificateExpirationDate	4/2/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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