29D2115274 CLIA NUMBER - APOLLO MEDICAL GROUP

Laboratory Demographics

CLIA Number: 29D2115274

Facility Name: APOLLO MEDICAL GROUP

Facility Address:
6330 W FLAMINGO RD STE 102
LAS VEGAS, NV
ZIP 89103
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Facility Phone Number: 702 444-7744

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1851766117

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	29D2115274
LAB Type	Physician Office
Facility Name	APOLLO MEDICAL GROUP
Street	6330 W FLAMINGO RD STE 102
City	LAS VEGAS
State	NV
ZIP	89103
Phone	702 444-7744
CertificateType	4
CertificateEffectiveDate	7/1/2022
CertificateExpirationDate	6/30/2024
FacilityType	Waiver

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