29D2055203 CLIA NUMBER - IRENE BENN MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 29D2055203
  • Facility Name: IRENE BENN MEDICAL CENTER
  • Facility Address: 10 LINCOLN ST
    MOAPA, NV
    ZIP 89025
  • Facility Phone: 928 669-3226
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: REBEKAH O. OSBORN
  • NPI Number: 1841535317
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 29D2055203
LAB Type Federally Qualified Health Center
Facility Name IRENE BENN MEDICAL CENTER
Street 10 LINCOLN ST
City MOAPA
State NV
ZIP 89025
Phone 928 669-3226
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2025
Certificate Expiration Date 3/5/2027
Facility Type Federally Qualified Health Center
Lab Director REBEKAH O. OSBORN

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This page was last updated on: 6/4/2025