29D2016305 CLIA NUMBER - NKDHC PLLC-NORTHWEST

Laboratory Demographics

  • CLIA Code: 29D2016305
  • Facility Name: NKDHC PLLC-NORTHWEST
  • Facility Address: 2450 FIRE MESA ST STE 110
    LAS VEGAS, NV
    ZIP 89128
  • Facility Phone: 702 853-0090
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUJATHA RAJU
  • NPI Number: 1265831432
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 29D2016305
LAB Type Physician Office
Facility Name NKDHC PLLC-NORTHWEST
Street 2450 FIRE MESA ST STE 110
City LAS VEGAS
State NV
ZIP 89128
Phone 702 853-0090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type Physician Office
Lab Director SUJATHA RAJU

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