29D2040249 CLIA NUMBER - SOUTHERN NEVADA OCCUPATIONAL HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 29D2040249
  • Facility Name: SOUTHERN NEVADA OCCUPATIONAL HEALTH CENTER
  • Facility Address: 4060 N MLK BLVD STE 101 A-B
    N LAS VEGAS, NV
    ZIP 89032
  • Facility Phone: 702 380-1712
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMIR K. NICKNAM
  • NPI Number: 1982060349
  • Taxonomy: 253Z00000X - In Home Supportive Care

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CLIA Record

Field Name Field Value
CLIA Number 29D2040249
LAB Type Physician Office
Facility Name SOUTHERN NEVADA OCCUPATIONAL HEALTH CENTER
Street 4060 N MLK BLVD STE 101 A-B
City N LAS VEGAS
State NV
ZIP 89032
Phone 702 380-1712
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Physician Office
Lab Director AMIR K. NICKNAM

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