29D2017176 CLIA NUMBER - NKDHC PLLC-NORTHEAST

Laboratory Demographics

  • CLIA Code: 29D2017176
  • Facility Name: NKDHC PLLC-NORTHEAST
  • Facility Address: 1581 MOUNT MARIAH DR STE 150
    LAS VEGAS, NV
    ZIP 89106
  • Facility Phone: 702 851-7766
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARWAN TAKIEDDINE
  • NPI Number: 1003297979
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 29D2017176
LAB Type Physician Office
Facility Name NKDHC PLLC-NORTHEAST
Street 1581 MOUNT MARIAH DR STE 150
City LAS VEGAS
State NV
ZIP 89106
Phone 702 851-7766
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 MARWAN TAKIEDDINE

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