29D2012126 CLIA NUMBER - LAS VEGAS PEDIATRICS

Laboratory Demographics

  • CLIA Code: 29D2012126
  • Facility Name: LAS VEGAS PEDIATRICS
  • Facility Address: 6070 S RAINBOW BLVD SUITE 10
    LAS VEGAS, NV
    ZIP 89118
  • Facility Phone: 504 250-8911
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MIMI KURIAKOSE
  • NPI Number: 1619671658
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 29D2012126
LAB Type Physician Office
Facility Name LAS VEGAS PEDIATRICS
Street 6070 S RAINBOW BLVD SUITE 10
City LAS VEGAS
State NV
ZIP 89118
Phone 504 250-8911
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2025
Certificate Expiration Date 1/26/2027
Facility Type Physician Office
Lab Director MIMI KURIAKOSE

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