29D2120850 CLIA NUMBER - RENOWN HEALTHY HEART PROGRAM

Laboratory Demographics

  • CLIA Code: 29D2120850
  • Facility Name: RENOWN HEALTHY HEART PROGRAM
  • Facility Address: 10085 DOUBLE R BLVD S MED PAV B STE 225
    RENO, NV
    ZIP 89521
  • Facility Phone: 775 982-4035
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BENJAMIN T. EBNER
  • NPI Number: 1295180735
  • Taxonomy: 261QR0404X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 29D2120850
LAB Type Physician Office
Facility Name RENOWN HEALTHY HEART PROGRAM
Street 10085 DOUBLE R BLVD S MED PAV B STE 225
City RENO
State NV
ZIP 89521
Phone 775 982-4035
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2024
Certificate Expiration Date 10/24/2026
Facility Type Physician Office
Lab Director BENJAMIN T. EBNER

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