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29D2138429 CLIA NUMBER - MAMA MIA PEDIATRICS-EASTERN

Laboratory Demographics

CLIA Number: 29D2138429

Facility Name: MAMA MIA PEDIATRICS-EASTERN

Facility Address:
1250 S EASTERN AVE
LAS VEGAS, NV
ZIP 89104
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Facility Phone Number: 702 383-4001

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1487167623

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

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
CertificateType 4
CertificateEffectiveDate 10/17/2023
CertificateExpirationDate 10/16/2025
FacilityType Waiver

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