29D2134653 CLIA NUMBER - ACTIVATE HEALTHCARE-IBEW LOCAL 357 CLINIC

Laboratory Demographics

  • CLIA Code: 29D2134653
  • Facility Name: ACTIVATE HEALTHCARE-IBEW LOCAL 357 CLINIC
  • Facility Address: 51 N PECOS RD STE 110
    LAS VEGAS, NV
    ZIP 89101
  • Facility Phone: 702 437-0227
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIDA THOMPSON
  • NPI Number: 1356865455
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 29D2134653
LAB Type Physician Office
Facility Name ACTIVATE HEALTHCARE-IBEW LOCAL 357 CLINIC
Street 51 N PECOS RD STE 110
City LAS VEGAS
State NV
ZIP 89101
Phone 702 437-0227
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2023
Certificate Expiration Date 8/6/2025
Facility Type Physician Office
Lab Director KIDA THOMPSON

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