29D2138429 CLIA NUMBER - MAMA MIA PEDIATRICS-EASTERN

Laboratory Demographics

  • CLIA Code: 29D2138429
  • Facility Name: MAMA MIA PEDIATRICS-EASTERN
  • Facility Address: 1250 S EASTERN AVE
    LAS VEGAS, NV
    ZIP 89104
  • Facility Phone: 702 383-4001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GABRIEL P. CARPO
  • NPI Number: 1487167623
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 29D2138429
LAB Type Physician Office
Facility Name MAMA MIA PEDIATRICS-EASTERN
Street 1250 S EASTERN AVE
City LAS VEGAS
State NV
ZIP 89104
Phone 702 383-4001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type Physician Office
Lab Director GABRIEL P. CARPO

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