29D2015816 CLIA NUMBER - MAMA MIA PEDIATRICS LLC

Laboratory Demographics

  • CLIA Code: 29D2015816
  • Facility Name: MAMA MIA PEDIATRICS LLC
  • Facility Address: 2315 E CHEYENNE AVE STE 100
    N LAS VEGAS, NV
    ZIP 89030
  • Facility Phone: 702 633-4000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GABRIEL P. CARPO
  • NPI Number: 1780049858
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 29D2015816
LAB Type Physician Office
Facility Name MAMA MIA PEDIATRICS LLC
Street 2315 E CHEYENNE AVE STE 100
City N LAS VEGAS
State NV
ZIP 89030
Phone 702 633-4000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2024
Certificate Expiration Date 11/3/2026
Facility Type Physician Office
Lab Director GABRIEL P. CARPO

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