29D2105695 CLIA NUMBER - DESERT REGIONAL CENTER

Laboratory Demographics

CLIA Number: 29D2105695

Facility Name: DESERT REGIONAL CENTER

Facility Address:
1391 S JONES BLVD
LAS VEGAS, NV
ZIP 89146
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Facility Phone Number: 702 486-6200

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1760544969

Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

CLIA Record

Field Name	Field Value
CLIA Number	29D2105695
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	DESERT REGIONAL CENTER
Street	1391 S JONES BLVD
City	LAS VEGAS
State	NV
ZIP	89146
Phone	702 486-6200
CertificateType	4
CertificateEffectiveDate	12/1/2023
CertificateExpirationDate	11/30/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024