29D2139720 CLIA NUMBER - PEAVINE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 29D2139720
  • Facility Name: PEAVINE FAMILY PRACTICE
  • Facility Address: 2005 SIERRA HIGHLANDS DR STE 101
    RENO, NV
    ZIP 89523
  • Facility Phone: 775 624-6492
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICARDO J. GONZALEZ
  • NPI Number: 1265958862
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 29D2139720
LAB Type Physician Office
Facility Name PEAVINE FAMILY PRACTICE
Street 2005 SIERRA HIGHLANDS DR STE 101
City RENO
State NV
ZIP 89523
Phone 775 624-6492
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2023
Certificate Expiration Date 11/6/2025
Facility Type Physician Office
Lab Director RICARDO J. GONZALEZ

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 3/20/2025